State Surveillance Program

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Every year, millions of the 135 million workers in the U.S. are injured on the job or become ill as a result of exposure to health hazards at work. In 2015, there were approximately 2.9 million nonfatal workplace injuries and illnesses reported by private industry employers, according to estimates from the Survey of Occupational Injuries and Illnesses (SOII) conducted by the U.S. Bureau of Labor Statistics (BLS). In addition, a preliminary report from the Census of Fatal Occupational Injuries (CFOI) by the BLS indicates that there were 4,679 fatal work injuries in the United States in 2014. Work-related injuries, illnesses, and deaths are very costly to American society. In 2014, employers spent $91.8 billion on workers’ compensation (National Academy of Social Insurance Data). Despite successes in reducing fatal and nonfatal occupational-related injuries and illnesses in recent years, the need for continued research and intervention activities in occupational safety and health (OSH) remains essential.

Work-related injuries and illnesses can be prevented, and successful approaches to making workplaces safer and healthier begin with having the data necessary to understand the problem. As part of its mission to prevent injuries, illness, and caused by hazards in the workplace, the NIOSH has established surveillance programs intended to assess the extent and severity (i.e., burden) of workplace injury and illness, to identify workers and occupations at greatest risk, to develop research and prevention priorities, and to measure the effectiveness of prevention activities. States have a central role in public health surveillance because they are uniquely positioned to utilize state-specific data sources and/or agreements for occupational health (OH) surveillance, and integrate surveillance with intervention and prevention activities as well as program evaluation.

Occupational safety and health surveillance presents numerous methodological and program-development challenges especially at the state level. Research is needed to evaluate existing surveillance systems and approaches. New approaches to capture the experience of special populations and/or factors (e.g., economic, legal) of workers who participate in nontraditional work arrangements is of interest. The use of nontraditional data sources and data linkages may be helpful for these surveillance efforts, but not fully understood and characterized.

The NIOSH surveillance research program acknowledges and values that states have a vital role to play in the surveillance of occupational injuries, illnesses, and hazards. In 2015, the Institute increased funding to support 26 state OH surveillance programs for funding up through June 2020. The research portfolio consists of 8 Fundamental Surveillance Programs, 11 Fundamental Plus Surveillance Programs and 7 Expanded Surveillance Programs. The research portfolio includes 49 projects addressing work related morbidity and mortality, exposure reduction, or special population of interest topics.  State OH surveillance systems and activities provide a vital foundation for several federal surveillance systems and augment other federal surveillance systems. A long-range NIOSH vision of a comprehensive surveillance research program would include all 50 States with core capacity or infrastructure to conduct surveillance of occupational injuries, diseases, and hazards that will contribute to State and local prevention efforts, as well as to national data concerning magnitude, trend, and distribution for OH morbidity and mortality.

For over 30 years, NIOSH has provided financial and technical assistance to state health and labor agencies to develop or expand OH surveillance program capacity and technical infrastructure. Examples include new data collection approaches, training and continuing education, acquisition of computers and software, informatics or methods improvements, contracting for specialized statistical expertise, and program webpage and resources. With recent years funding, the breadth and depth of 26 state OH surveillance program accomplishments and major outputs are evident in the annual report. In recent years, NIOSH and states have increasingly collaborated in joint publications, presentations and workshops, webinars, and for data ‘quality check’ for OH Indicators (i.e., measures of work related health, diseases, injury or factors associated with health) before publication. The Indicators are intended to be used in conjunction with other guidelines for state OH surveillance of occupational injuries and illnesses (NIOSH 1995, CSTE 2013) and to be used as a complement to overall state and national goals to improve the health of the population (DHHS 2000). In addition, NIOSH works with other CDC programs to incorporate occupational information into CDC surveillance activities e.g., Health People 2020, NCIPC injury surveillance.


The primary purpose of the PAR is to provide financial and technical support to states for the development or expansion of an occupational health and safety (OHS) surveillance program including data acquisition-analysis-dissemination of findings (up to 20 consensus Indicatorsexternal icon); outreach and partnership development; prevention intervention recommendation; and state-proposed surveillance priority research projects. OH surveillance is the ascertainment and tracking of occupational injuries, illnesses, deaths, hazards, or exposures to support and enhance prevention of these outcomes and conditions. OH surveillance includes worker population/group- and case-based approaches and activities. Occupational surveillance data are used to identify state priorities and guide efforts to improve and protect worker safety and health; monitor statistical and other trends and progress over time; and develop prevention intervention strategies and recommendations. Partnerships are integral to the NIOSH OH Surveillance Program. Partners add expertise or specialized experience to the research team and have access to select data sources which benefits the collection, analysis, interpretation, and communication of results.

Healthy People 2020 and other National strategic priorities: Occupational safety and health related Healthy People 2020external icon objectives are primarily addressed through the National Occupational Research Agenda (NORA). NORA was established by the Centers for Disease Control and Prevention (CDC) NIOSH and its partners to stimulate research and improve workplace practices. Now in its second decade (2006–2016), NORA focuses on occupational safety and health in 10 sectors available at www.healthypeople.govexternal icon. Ten occupational health and safety goals have been identified for prioritizing and guiding research and public health practice. In addition, NIOSH is interested in monitoring changes in the workforce, workplace, work organization factors, and emerging issues in OSH. For example, in recent years states have served in meaningful investigational, educational and/or outreach roles for work-related non communicable disease clusters or events.

Public Health Impact: NIOSH expects this FOA to have meaningful impact on: 1) OH surveillance and epidemiology and public health research, 2) dissemination and use of findings for the incidence and/or prevalence of occupational injuries, illnesses, deaths, and exposures; 3) identification of surveillance trends, emerging issues, high-risk occupations, industries, and worker populations; 4) audience-specific educational materials, outreach and other resources for optimizing their uptake or adoption or adaptation for protecting workers; and 5) development and dissemination of public health recommendations for workplace interventions. These goals foster the integration of occupational public health into broader public health goals and objectives.

Relevant work: NIOSH is an active partner in OH surveillance and epidemiology in terms of developing ‘consensus’ goals , programs and scientific coordination, sharing OSH data and research statistics, and for communicating national and regional major accomplishments and  impact.  NIOSH has also co published surveillance and epidemiology articles for OH exposures and illnesses in cooperation with state programs. NIOSH collaborates and coordinates with the CSTE for occupational public health including strategic, scientific, technical and programmatic components. More recently, NIOSH established a virtual workers compensation data program/office to explore opportunities for use of this type of data to improve worker protection.

NIOSH Sponsored State Occupational Health Safety Surveillance Program 2018

State Program Description

Fiscal Year (FY) Extramural Research Program Highlights

Program achievements featured in the Extramural Research and Training Program Annual Reports

Funding Opportunity Announcements

All cooperative agreement funding opportunity announcements can be found at:

Page last reviewed: January 3, 2018