FY 2020 Extramural Research Program Highlights: Multidisciplinary Centers
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 2020.
Centers for Agricultural Safety and Health
The 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) 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 more than 30 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 2020:
- 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, 2019, through September 30, 2020, Ag Centers published 59 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.
Cross-center Collaborations to Protect the Safety and Health of Workers
The NIOSH-supported Ag Centers have a long history of cross-center collaboration, including outreach, educational, evaluation, and research activities. These partnerships among the centers have created a strong, nationwide network of academic and medical research institutions devoted to addressing morbidity and mortality among AFF workers, and their families. While housed in 11 institutions across the country, this network is driven and maintained by a large group of interconnected researchers, communicators, educators, evaluators, and other contributors. Many of these individuals train and work at other institutions in the network outside of their own. The camaraderie created through the shared histories and experiences of those in the network strengthens their collective approach and impact while improving the lives of people working in AFF.
Additionally, many of the collaborations and connections between the Ag Centers develop through their outreach efforts. The Centers have numerous long-standing collaborative initiatives. Evaluation, coordination, and outreach staff at the centers network through regular meetings and support each other in various aspects of their center’s outreach activities. These meetings and connections improve efficiency and create synergies in areas where centers are working on the same topic or with similar target populations. Examples include fact sheets created by one center and used by others, and the coordination and sharing of multilingual materials and educational campaigns. Next are examples how the Ag Centers work together to respond to particular workforce needs.
Using YouTube for Widespread Reach and Awareness in Agriculture, Forestry, and Fishing
In 2013, the Ag Centers partnered to start a YouTube channel that uses videos to raise awareness of hazards and provides information to prevent injuries and illnesses in AFF. The videos are posted in multiple languages including English, Spanish, and K’iche. Through YouTube, the centers also aim to increase their visibility and sphere of influence and create a model of collaborative work that can be used by other organizations. The centers set up policies, procedures, and a standard review process for videos posted on its YouTube page to ensure high scientific standards. They have a joint marketing plan to promote the channel to agricultural cooperative extension agents, educators, producers, owners, operators, first responders, families, and community organizations. The centers disseminate this information through email, social media, conference presentations, and outreach exhibits.
The YouTube channel currently features 167 videos, which are the total number that have been posted since 2013. People watched the videos 426,764 times from 2013 through 2020. The videos with the most views are on safe use of chain saws and grain bin safety. In FY 2020, people viewed the videos 108,050 times. You can find more information on this project at the links below.
Details:
- U.S. Agricultural Safety and Health Centers
- Development of an Educational YouTube Channel: A Collaboration Between U.S. Agricultural Safety and Health Centers
Preventing Injuries and Death Through the Rollover Protective Structures Program
Tractor overturns, a long-standing concern in agriculture, are the leading cause of farm-related fatalities. Recognizing this problem, the Ag Centers have been active since their beginning to try to lessen the circumstances that lead to these tragic incidents. Rollover protective structures, or ROPS, which became standard tractor equipment in 1985, help prevent injuries from tractor overturns. However, many tractors made before that time are still in use. The Ag Centers proposed the National Agricultural Tractor Safety Initiative in 2004, a broad plan of action to bolster ROPS efforts. Since this time, the centers have worked individually on specific research or technical ROPS issues while also cooperating and supporting each other collectively on varied ROPS-related projects including education and outreach. Notably, the Northeast Center for Occupational Health and Safety created a successful ROPS Rebate Program in New York State, addressing barriers that farmers face related to retrofitting or adding ROPS on tractors. The program relies on state funding to provide incentives, such as a rebate of approximately 70% of the cost to retrofit a tractor (including purchase of the ROPS kit, shipping, and installation). A cost-inclusive evaluation of the program showed ROPS saved more than $4 million in prevented deaths and injuries among New York State farm workers from 2007 through 2017.
In 2017, the Northeast Center started building on National Tractor Safety Coalition (NTSC) efforts to launch a National ROPS Rebate Program. The center collaborates with NTSC partners to address manufacturing design and supply concerns related to ROPS. They also work together to increase interest among agricultural partners related to expanding the National ROPS Rebate Program. To support this effort, Northeast Center researchers recently conducted a study on how interested groups in agriculture perceive the expansion of the ROPS Rebate Program and the use of media as an implementation strategy for agricultural safety. In FY 2020, the research team analyzed their results and developed recommendations, published in BMC Public Health. The study showed the importance of using media before, during, and after implementation of a ROPS program to get and sustain support. Scientists also received a NIOSH-funded investigator-initiated research grant (R01) in FY 2020 to put strategies into place from the study to create a ROPS Rebate Program in states at high risk for overturn fatalities. This new project will focus on three high-risk states—Kansas, Iowa, and Missouri.
The previously mentioned ROPS efforts show how coordination and collaboration among the Ag Centers can be topic focused. These also illustrate how each center’s involvement can fall on varied points of the research to practice (r2p) spectrum.
Details:
- Northeast Center for Occupational Health and Safety Agriculture, Forestry, and Fishing: Summary Annual Report Fiscal Year 2020
- Stakeholder Experiences Implementing a National ROPS Rebate Program: A Grounded Theory Situational Analysis
- An Exploration of Rollover Protective Structures (ROPS) Rebate Program Media Coverage: Strategies for Implementation and Sustainment
- Outside NIOSH: Costs From Injuries and Deaths Decrease After State Program Promotes Rollover Protective Structures for Tractors
- NIOSH Agricultural Safety and Health Centers: National Agricultural Tractor Safety Initiative January 2004 Upper Midwest Agricultural Safety and Health Center (UMASH)
National Farm Safety and Health Week
In 1944, the National Safety Council began recognizing National Farm Safety and Health Week (NFSHW). The same year, U.S. President Franklin D. Roosevelt proclaimed it as a nationally recognized week, and every president since then has done the same. During this third week in September, the goal is to widely promote messages and resources on a range of farm safety and health topics. NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2020 23 Each day of the week has a different theme, and the weekly theme changes annually. Because agriculture ranks among the most hazardous industries, with farmers remaining at very high risk for fatal and nonfatal injuries, NFSHW continues to remain relevant in the AFF sector. Since 2014, the Ag Centers have collaborated on an annual NFSHW campaign, partnering to create and disseminate a campaign communication toolkit that includes resources aligned with the NFSHW daily themes that amplify useful communication tools, like the National YouTube Channel. The toolkit also highlights best practices and offers guidance and other critical information related to agricultural safety and health. The centers designed the toolkit for users to share via multiple communication channels, including social media, websites, and print and broadcast media.
NFSHW 2020 featured the overall theme of Every Farmer Counts, and the Ag Centers shared their toolkit resources, which fit with each daily theme during the week, via social media channels. Data collected from 9 of 11 centers on Twitter and Facebook (FB) metrics showed that people viewed their FB posts more than 11,000 times. More than 1,500 FB users engaged with these posts by either liking, sharing, or commenting on them. Centers estimate that all Twitter posts combined reached more than 12,000 users.
Details:
Saving Lives Through Telling the Story
“We don’t want this to happen to anyone else” is the basic message of the Telling The Story Project. It uses personal stories and first-hand experiences from farmers and other agricultural workers, along with their families and community members, to reach at-risk populations in the agricultural industry. This project is based on research from public health, psychology, sociology, and organizational development that supports the use of storytelling as an effective communication and marketing approach.
Through storytelling, the individuals featured in the Telling The Story Project discuss ways they have been impacted by injuries, fatalities, and close calls or circumstances where they could have been hurt. Their narratives are told in their own words and provide valuable information and insight to help prevent others from having similar incidents in the future. The Telling The Story Project started in 2016 and is a collaborative outreach and educational campaign between four centers in the Midwest—the Central States Center for Agricultural Safety and Health, Great Plains Center for Agricultural Health, Upper Midwest Agricultural Safety and Health Center, and National Farm Medicine Center.
More information about this project is available at the website shown below, which has over 18,000 views. Created by the Telling The Story team, the website highlights the personal narratives, along with videos, educational resources, safety vignettes, and study or discussion guides related to safety and health in AFF. Web visitors downloaded the study guides more than 300 times since their creation in 2018. These resources provide additional information on the hazards outlined in each featured story. Multiple news outlets in the agricultural industry have featured stories from the Telling The Story Project. These include the Angus Beef Bulletin, Wisconsin State Farmer, Morning Ag Clips, and AgNet West.
Details:
- Telling The Story: Tell a Story, Save a Life
- Being in a Hurry Is No Excuse for an Unsafe Act
- New Project Helps Farmers Share Safety Messages
- Telling The Story Project Saving Lives
Developing a National Model of Agricultural Safety and Health Education
In 1987, the Agricultural Health and Safety Course started at the University of Iowa (UI) College of Public Health. Originally focused on medical professionals, the course expanded to include safety professionals and others working with agricultural communities. This educational program focuses on key health and safety issues for rural and agricultural workers and includes presentations relevant to those working in occupational safety and health, health care, public health, and education. In 2007, the NIOSH-funded Great Plains Center for Agricultural Health (GPCAH) at UI started disseminating the course nationally and internationally. GPCAH later partnered with two other Ag Centers on the project—the Central States Center for Agricultural Safety and Health and Southwest Center for Agricultural Health, Injury Prevention, and Education.
Other organizations across the United States have also adopted the course, as shown on the Agricultural Safety and Health: The Core Course webpage. A consensus process with national and international experts guides the development and continuous revisions of the content for this week-long course. The course focuses on prevention and the hierarchy of controls for occupational hazards. It includes live lectures, small-group discussions, online modules, podcasts, case studies, homework assignments, and interactive exercises.
Course topics include safety and industrial hygiene, respiratory diseases, children and aging workers on farms, traumatic injury, zoonotic diseases, livestock handling, behavioral health, pesticides, ergonomics and musculoskeletal disorders, and personal protective equipment. The course provides the information and skills to help individuals anticipate, identify, and prevent workplace injuries and illnesses in the agricultural industry. Individuals completing the course can receive academic credit, continuing education, and a certificate of completion.
Since 2011, 1,391 trainees from the United States and Australia participated in 39 courses. In FY 2020, the course occurred five times, and a total of 285 people participated. A survey completed by course participants six months later showed 80% of them believed their ability to anticipate, diagnose, treat, or prevent agricultural injuries and illnesses improved. Almost 90% indicated the course information helped them address occupational hazards, and 70% felt confident when recommending personal protective equipment for the farming population.
GPCAH also created separate online education from the Agricultural Health and Safety Course that includes some of its course topics. These online modules are freely available and offer a certificate of completion. The Agricultural Health and Safety Course has become a national model of effective agricultural safety and health education.
Details:
- Agricultural Health and Safety Course for Medical and Safety Professionals
- Annual Report September 2019–August2020: Central States Center for Agricultural Safety and Health
- Online Training Agricultural Safety and Health
Building Capacity for Effective Evaluation
In FY 2020, the Ag Centers collaborated with NIOSH to start building evaluation capacity across the AFF Program. NIOSH recently developed an Evaluation Capacity-Building Plan (2021–2025) outlining institute evaluation needs and steps to address those needs over a five-year period. As a part of the plan, NIOSH staff collaborated with Ag Centers to develop a shared understanding of evaluation concepts, definitions, and frameworks which we can apply to our programs and research projects. This includes definitions for common evaluative terms such as outputs, intermediate outcomes, and end outcomes, as well as an introduction to the framework that NIOSH uses to guide its program reviews. This has allowed the centers to work together with NIOSH to develop shared logic models on common AFF health and safety topics, including heat-related illness and rollover protective equipment. These models will enable Ag Centers and NIOSH AFF Program leaders to assess the progress made to date, identify gaps that may still exist, and make informed decisions about the future direction of the program.
National Center for Construction Safety and Health Research and Translation
CPWR—The Center for Construction Research and Training received a NIOSH cooperative agreement to be the National Center for Construction Safety and Health Research and Translation for 2019–2024. CPWR received this funding through an extramural competition and has received NIOSH funding for the past 30 years through a series of competitive funding announcements. The center, with its diverse construction community, leads in the field of 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 projects 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. The center has cultivated and optimized external partnerships for prevention, protections, research, and research translation for protecting U.S. construction workers. A recent evaluation of the NIOSH Construction Program recognized CPWR for the value of its research translation focused efforts in construction.
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, 2019, through September 30, 2020, CPWR published 13 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.
National Stand-Down to Prevent Struck-by Incidents
In the construction industry, struck-by incidents are a leading cause of death and have topped the leading cause of nonfatal injuries since 1992. Most workers are struck by flying, swinging, or rolling objects, according to the Occupational Safety and Health Administration. In FY 2020, CPWR joined the NORA Construction Sector Council in launching the first-ever National Stand-Down to Prevent Struck-by Incidents. This inaugural event aimed to increase awareness of both struck-by hazards, as well as approaches for preventing these incidents. Held during National Zone Awareness Week in April, the event featured a virtual question and answer (Q&A) panel with experts who talked about struck-by hazards in work zones and ways to prevent these from occurring on job sites. A variety of resources for the National Stand-Down to Prevent Struck-by Incidents were also available, including training materials, toolbox talks, and webpage. Almost 700 people attended the virtual event, and 1,708 people viewed the virtual Q&A from April 22, 2020, through August 31, 2020. In addition, 386 people accessed CPWR’s Struck-by-Injuries webpage and additional materials from September 1, 2019, through August 31, 2020.
Details:
New Tool to Support Construction Companies in Improving Safety Climate
A key leading indicator of a company’s jobsite safety is having a strong positive safety climate—defined as employees’ shared perceptions that a company’s stated safety policies and procedures are consistent with actual jobsite practices. In 2016, CPWR developed the Safety Climate Assessment Tool (S-CAT) to help construction companies evaluate their jobsite safety climate maturity across eight leading safety climate indicators. In 2018, they also developed the Safety Climate Assessment Tool for Small Contractors (S-CATsc), which is a simple needs assessment based on the S-CAT’s eight leading indicators. While both provide guidance on how to strengthen jobsite safety climate, neither offer actual safety management resources companies can use to improve their climate scores.
To fill this gap, CPWR is creating a new interactive online tool called the Safety Climate-Safety Management Information System (SC-SMIS). SC-SMIS users will be able to (1) conduct jobsite safety climate assessments using the S-CAT and/or S-CATsc, (2) select from over 80 evidence-based safety management resources to target and improve low-scoring safety climate indicators, (3) develop plans to put the resources into action, (4) schedule reminders to conduct periodic assessments, and (5) implement new resources for continuous safety climate improvement. CPWR expects to finalize and begin offering the SC-SMIS by the end of FY 2021. To complement the SC-SMIS, CPWR is developing a new Confidence to Implement scale to measure a safety professional’s confidence to identify, implement, and evaluate the effectiveness of safety management resources. The center believes this tool will help these safety professionals better understand their strengths and needs in terms of safety climate and safety management improvement activities.
Details:
- Safety Climate-Safety Management Information System (SC-SMIS)
- Outside NIOSH: Tool Helps Construction Companies Evaluate Jobsite Safety Climate
Advancing Women in the Trades: New Mentoring Program to Improve Safety, Health, and Well-being
Women working in the trade industry face many challenges, including a higher likelihood of discrimination and harassment compared with men, and their skills are often underutilized, according to research. More so in the construction industry, women represent a small portion of the workforce and leave construction apprenticeship programs at high rates, possibly due to these challenges. Researchers funded by CPWR at the University of Washington are now developing and testing a mentoring program for women in construction, promoting safety, health wellbeing. They are partnering with a labor union on this project—the International Association of Sheet Metal, Air, Rail, and Transportation Workers (SMART).
The goal of the program is to increase these construction workers’ self-knowledge, self-efficacy, and skills related to advocating for safety, ultimately reducing injury risks and psychological stressors at work. Journey-level, or skilled, construction workers from local SMART unions in the study will mentor female apprentices. The mentors will get training on effective mentoring techniques and program content. A group of 100 women will receive mentoring while another group of 100 female apprentices will not during a two-year period. Throughout the study, researchers will assess both groups to measure the program’s impact, with a focus on changes in their stress levels, coping mechanisms, safety climate at work, and job retention.
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Centers of Excellence for Total Worker Health®
In FY 2020, NIOSH funded six Centers of Excellence for TWH, located throughout the United States, to explore and research TWH-related concepts. 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-related research and practice:
- 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, 2019, through September 30, 2020, the Centers of Excellence published 50 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.
U.S. Surgeon General Highlights NIOSH TWH Approach
In an article in Public Health Reports, the U.S. Surgeon General, Vice Admiral (VADM) Jerome Adams, MD, MPH, highlighted the Centers of Excellence for TWH, along with the NIOSH Office of TWH and NIOSH TWH affiliates. The article focused on the important relationship between employment and health. The U.S. Surgeon General recommended that employers and companies ensure that worker well-being programs are implemented more broadly and meet the needs of workers—an approach that can lead to better health and business outcomes. He mentioned successful research and practice for worker well-being from the NIOSH Office of TWH and the Centers of Excellence for TWH. One center project he mentioned included the Health Improvement Through Training & Employee Control Program from the Center for the Promotion of Health in the New England Workplace (CPH-NEW). However, while the article acknowledged the centers’ work and NIOSH, it noted that more research is needed on workplace well-being interventions across varied settings that shows the positive impacts on multiple health, human capital, and financial outcomes. Through partnerships among public health leaders, academia, employers, and other interested parties—like the one between NIOSH and the Centers of Excellence for TWH—the U.S. Surgeon General believes we can help workers achieve their highest potential.
Details:
- The Value of Worker Well-being
- U.S. Surgeon General Highlights the Value of Worker Well-being and the NIOSH Total Worker Health® Approach
Connecticut Department of Corrections Adopts TWH-Oriented Training Programs
Based on past studies, CPH-NEW found that correctional officers developed high risks factors for chronic disease within the first five years of working. They often experienced obesity, hypertension, physical inactivity, and high levels of depression, along with poor sleep and nutritional habits. To address this issue, CPH-NEW researchers conducted a study focused on peer health mentoring for new cadet correctional officers known as “Health Improvement through Training & Employee Control (HITEC II).” HITEC II researchers and the Connecticut Department of Corrections developed design teams combining a Kaizen design approach and CPHNEW’s IDEAS process. Correctional officers and supervisors on the teams created TWH interventions for workplace safety and health concerns. The teams created intervention programs, including educational trainings on mental health, prevention of substance use and misuse, and nutrition.
The supervisors involved are also a part of the Correction Supervisors Unit (NP-8) of the Service Employees International Union, Local 2001. In FY 2020, the Connecticut Department of Corrections started permanently funding and offering the trainings to employees as part of a union collective bargaining agreement. Employees now have formal training days to participate in the programs, but their involvement is voluntary. So far, more than 40% of all corrections supervisors have participated in the trainings.
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You OK? Center Develops National Suicide Prevention Campaign for Construction Trade Association
In the United States, suicide is the 10th leading cause of death, claiming the lives of nearly 48,000 people in 2019, according to the National Institute of Mental Health. More so, the construction industry has one of the highest suicide rates compared with other industries. To address this issue, the Association of General Contractors (AGC), a construction industry trade association, developed a suicide prevention campaign with the Healthier Workforce Center of the Midwest. Before the campaign, the center worked with the AGC chapter in Missouri and center-funded researchers at Washington University at St. Louis on projects to improve the safety, health, and well-being of construction apprentices. The collaboration led national AGC leadership to recruit this group to work on its suicide prevention campaign for construction workers. They joined a small team of union safety professionals and representatives from large contractors for the project. The suicide prevention campaign called “You OK?” launched in September 2019 during National Suicide Prevention Week. This ongoing campaign includes freely accessible materials including medallions, hard hat stickers, posters, and toolbox talk handouts. Throughout FY 2020, 185 individuals requested campaign materials and several large Missouri construction companies have shared this information with hundreds of employees during Safety Stand-Down events. The Healthier Workforce Center of the Midwest now has plans to nationally expand the campaign.
Details:
- Suicide Prevention Campaign for the Workplace
- Partnering to Prevent Suicide in the Construction Industry—Building Hope and a Road to Recovery
The Oregon Healthy Workforce Center Dissemination Workgroup
The Dissemination Workgroup at the Oregon Healthy Workforce Center focuses on the center’s use of best practices for disseminating, or sharing, its intervention research. The Workgroup developed multiple products including the Health Impacts Safety toolbox and safety meeting guides, which are given out at conferences and available online. Through these resources, organizations can learn more about the center’s TWH-related work and use this information to integrate workplace safety, health, and well-being. In FY 2020, more than 400 people downloaded the Health Impacts Safety materials online. The workgroup also created a webpage, YourWorkpath.com, to share all the center’s toolkits and TWH-related resources in one space. In FY 2020, 1,264 individuals visited the page.
Two organizations, the State Accident Insurance Fund Corporation (SAIF) in Oregon and Eskenazi Health in Indiana, developed partnerships with the center after their staff visited the page and will adopt or use the center’s Safety and Health Improvement Program (SHIP). Eskenazi has plans to roll out the SHIP training program throughout its hospital system, and SAIF will include SHIP in its series of manager-focused training programs, called “Leadership Project.” The Dissemination Workgroup also built a collaboration between the Oregon Healthy Workforce Center and a community college in the Midwest, focused on the Promoting U through Safety & Health toolkit. The college plans to first distribute the toolkit to workers and students from ages 18 through 45 years on two of its four campuses. After this, it will eventually roll out the toolkit to more than 3,000 individuals across all four of its campuses and satellite locations.
Details:
- Health Impacts Safety
- YourWorkpath.com
- Celebrating the Relaunch of Our Safety and Health Improvement Program (SHIP) Toolkit
- Total Worker Health in Young Workers
Study Identifies Policy Recommendations and Gaps From TWH Research
The Center for Work, Health, and Well-being has conducted the first literature review of TWH research articles, focused on identifying policy implications. As a part of its Policy Working Group, the center’s researchers analyzed its peer-reviewed publications over 7½ years that focused on links between work conditions and health outcomes. They looked at the literature for scientific findings addressing organizational or public policies and identified common themes or topics. The scientists reviewed 32 of 57 peer-reviewed articles published from 2011 through mid2019 that fit the study’s inclusion criteria and found 12 cross-cutting or broad themes focused on policies. These included (1) ergonomic practices, (2) harassment and abuse, (3) safety practices, (4) social support, (5) staffing levels, (6) work-family conflict, (7) work schedules, (8) work stress, job demands and decision-making, (9) injuries and injury reporting, (10) mental health, (11) physical activity, and (12) sleep deficiency. The themes were grouped and reported in two categories—working conditions and related health outcomes—categories that researchers report influence each other. This finding supports a core component of the TWH concept that multiple working conditions can interact and influence one another and health outcomes.
Beyond being the first of its kind, this study is significant because policies are key to the integration of TWH practices in the workplace and its influence on worker well-being. The research identified themes for policy recommendations from TWH research, as well as gaps where future research is needed on policies. In FY 2020, the Journal of Occupational and Environmental Medicine published these findings.
Details:
- Literature Review of Policy Implications From Findings of the Center for Work, Health, and Well-being
- Harvard T.H. Chan, School of Public Health: Center for Work, Health & Well-being
Launch of the Get Outdoors Employer Toolkit
In FY 2020, the Center for Health, Work & Environment created the Get Outdoors Employer Toolkit, in partnership with the Office of Outdoor Recreation at the Colorado Office of Economic Development and International Trade. The toolkit includes free resources for businesses to support a healthier employee lifestyle through integrating and promoting nature experiences and outdoor recreation into workplace initiatives. A workplace focused wellness and health survey is included in the toolkit. Those who complete this assessment receive a set of recommendations on ways their company can improve health and wellness programs through outdoor activities. Through the assessment and resources, the Center for Health, Work & Environment expects to improve the health and well-being of diverse Colorado workforces. The toolkit also aligns with the Colorado Governor’s Health Initiative to lower healthcare cost by encouraging state residents to get outside.
The center promoted the toolkit to leading Colorado employers in the manufacturing, healthcare, construction, and retail industries, and the media also widely promoted it. So far, 51 companies of varied sizes and industries have completed the assessment in the toolkit and received guidance on how to support employee well-being. The center plans to launch the first Get Outdoors Healthy Workplace Award in October 2020, recognizing companies based on their assessment results.
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Community Interventions for Safer and Healthier Work
Building on data from a past assessment of two Chicago neighborhoods with high levels of unemployment and/or residents in precarious work, the University of Illinois at Chicago (UIC) Center for Healthy Work is developing community interventions. The center is using the assessment results, and a theory of change and strategic road map resulting from it, to create a healthy work culture within the community. The four interventions are a part of the Greater Lawndale Healthy Work (GLHW) Project and focus on community perceptions and strong community infrastructure that support healthy work, along with fair work opportunities within neighborhoods.
Members of the GLHW Council are creating and will pilot test the following interventions within Chicago’s Greater Lawndale area:
- An educational campaign that includes an interactive bingo/lotería game, art, and events focused on changing beliefs on work and health among community members, workers, employers, and policy makers through highlighting work as a human rights and social justice priority.
- Training and outreach materials on workers’ rights that will be distributed to temporary staffing agencies and then customized and widely shared by these companies.
- Education and advocacy for policies that increase opportunities to build community wealth and spending through more support of local entrepreneurship, small businesses, and cooperative businesses.
- Characterization of COVID-19 impact on communities and related resident needs and use of this information to modify GLHW interventions.
Through the GLHW Project, UIC Center for Healthy Work continues to explore ways to implement safer and healthier approaches to work that extend into the community.
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Education and Research Centers
NIOSH is mandated to provide an adequate supply of qualified personnel to carry out the purposes of the Occupational Safety and Health Act (Public Law 91-596 ), and the ERCs are one of the principal means for meeting this mandate. ERCs are academic institutions that provide high-quality interdisciplinary graduate and post-graduate training, research training, education, and outreach in the core occupational safety and health disciplines of industrial hygiene, occupational health nursing, occupational medicine residency, and occupational safety, as well as allied disciplines. Research and research training are integral components of ERCs, with ERC faculty and NIOSH trainees conducting research on issues related to the NIOSH Strategic Plan: FYs 2019−2024 and emerging issues. ERCs serve as regional resources for industry, labor, government, and the public through training, research to practice, education, and outreach.
NIOSH Education and Research Centers

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 2030—to promote the health and well-being of the workforce—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, 2019, through September 30, 2020, the ERCs published 215 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 2019–2020, more than 300 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 increased from 978 in FY 2019 to 997 in FY 2020. The table shows the number of students enrolled, graduates, and employment status during FY 2020.
Table. ERC Trainees, Graduates, and Employment, FY 2020
Program Area | Enrolled | Graduates | Employed or seeking occupational safety and health employment (%) |
---|---|---|---|
Industrial Hygiene | 292 | 115 | 108 (94) |
Occupational Health Nursing | 137 | 30 | 28 (93) |
Occupational Medicine | 129 | 34 | 33 (97) |
Occupational Safety | 161 | 53 | 53 (100) |
Other Related Disciplines | 278 | 71 | 63 (89) |
Total | 997 | 303 | 285 (94) |
The table below shows the placement of FY 2020 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 2020
Work Setting/ Program Area |
Industrial Hygiene |
Occupational Health Nursing |
Occupational Medicine |
Occupational Safety |
Other |
Total |
---|---|---|---|---|---|---|
Private Industry | 48 | 0 | 2 | 34 | 21 | 105 |
Federal/ State/Local Government |
22 | 3 | 3 | 1 | 13 | 42 |
Academic Institution |
13 | 4 | 1 | 5 | 13 | 36 |
Clinic/Hospital | 3 | 14 | 23 | 4 | 1 | 45 |
Other OSH Employment |
1 | 0 | 2 | 1 | 2 | 6 |
Seeking Advanced OSH Degree |
5 | 2 | 0 | 5 | 12 | 24 |
Seeking OSH Employment |
16 | 5 | 2 | 3 | 1 | 27 |
Total | 108 | 28 | 33 | 53 | 63 | 285 |
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 2020, ERCs provided 306,952 person hours of training to 73,695 occupational safety and health professionals who took 1,543 courses. This compares with FY 2019 when the ERCs offered more courses (1,562) and more hours of training (348,390) but had a lower number of trainees (51,153).
Table. Continuing Education Courses by Discipline, FY 2019
Discipline | Number of Courses |
Number of Trainees |
Person-Hours of Training |
---|---|---|---|
Industrial Hygiene | 159 | 4,928 | 32,331 |
Occupational Health Nursing | 129 | 8,176 | 34,254 |
Occupational Medicine | 209 | 28,270 | 40,342 |
Occupational Safety | 805 | 20,837 | 143,954 |
Other | 241 | 11,484 | 56,071 |
Total | 1,543 | 73,695 | 306,952 |
ERC Program Achievements
Center Focuses on Work Ability Among Older Nurses
Many older nurses in the United States are working in direct care and facing safety and health hazards, but research is limited on their ability to safely perform at work. Researchers at the New York and New Jersey ERCs recently looked at the factors influencing aging nurses’ work ability. They interviewed 17 female registered nurses, with an average age of 59 years, by phone or in person at a large academic medical center. Guided by a NIOSH Organization of Work Framework, the questions focused on the framework’s principles that include work context, or characteristics of the job like work tasks and roles, and organizational context, like workplace practices and policies.
The participants’ main motivations were internal factors like experiencing joy from nursing and feeling connected to patients at their bedside. Other aspects that increased their ability to work included having a preferred work schedule that supported work-life balance, a work environment filled with camaraderie and teamwork, and organizational leaders who valued workers’ input. These nurses also identified health issues, including knee replacement surgery, as one barrier to work performance—especially related to their desire to work future. Most expected to continue working for 5–10 more years.
While researchers say future research needs to reflect a wider population and range of healthcare systems, these findings support the need for managers of aging nurses to focus on schedules, workload, and enhancement of overall health. The Western Journal of Nursing Research featured this study, as did a NIOSH Science Blog in FY 2020 commemorating nurses during the Year of the Nurse. So far, more than 400 people have read about the study.
Details:
- NIOSHTIC-2 Publications Search: Organization of Work Factors Associated With Work Ability Among Aging Nurses
- New York-New Jersey Occupational Safety & Health Center
- Work Ability Among Older Nurses
The Widespread Reach and Influence of Harvard’s Continuing Professional Education
Continuing professional education and outreach at the Harvard ERC offers a varied slate of courses that meet regional, national, and global occupational safety and health needs. These Executive and Continuing Professional Education Courses (ECPE) are short classes, ranging from two to five days, taught by staff in the Harvard T.H. Chan School of Public Health. Course participants include current and aspiring global leaders in healthcare and public health, with up to 55 individuals participating in each class.
Topics can range from leading in healthcare systems and organizations to applied risk communication to health outcomes research. These four topics are typically included each year and were the only classes offered in-person in FY 2020 due to the COVID-19 pandemic:
- Comprehensive Industrial Hygiene
- In-place Filter Testing Workshop
- Ergonomics and Human Work Factors
- Radiological Emergency Planning
The Harvard ERC offered 46 courses attended by 1,763 people in FY 2020. Participants included state police, firefighters, and first responders, along with hospital and university staff. Representatives from the U.S. Air Force, U.S. Navy, Federal Emergency Management Agency, and U.S. Nuclear Regulatory Commission also participated. Class evaluations showed most participants thought the courses would improve their job performance. When asked to rate the overall quality, participants gave the courses an average score of high quality. Looking forward to FY 2021, ECPE courses will be held online. The Harvard ERC hopes this approach will make the program more accessible to new participants.
Details:
Symposium Highlights Key Topics Related to Wildfires
The Southern California ERC, located jointly at University of California Los Angeles and University of California Irvine, hosted a symposium on wildfires—an issue that continues to increase in severity and length in the Western United States. This event, entitled “Hot Topics in Wildfires: Present and Future Health Risk,” focused on varied topics such as health effects from wildfires, regulations for worker protection from wildfire smoke, and the impact of climate change on wildfires. Presentations also highlighted past and current NIOSH research on wildland firefighters. Additionally, sessions focused on exposure assessment in wildfire research including biomonitoring, exposure monitoring, and computer modeling. Presenters represented universities, state health departments, and other organizations, including the University of California San Francisco, University of Arizona, and California Department of Public Health. Symposium attendees included local government officials from Los Angeles and Irvine, along with staff at the Irvine Police Department and Orange County Fire Authority.
This February 2020 event aligned with the Southern California ERC’s efforts to provide professional education, research, and outreach that positively impacts regional and national occupational health and safety practice.
Details: