State Occupational Health & Safety Surveillance Program

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Each year, millions of workers in the United States are injured on the job or become ill as a result of exposure to health hazards at work. In 2018, 5,250 U.S. workers died from occupational injuries according to the Census of Fatal Occupational Injuries Summaryexternal icon. Although deaths from work-related illnesses are more difficult to count, a 2011 publicationexternal icon estimated that 53,445 work-related deaths occur annually.

In 2018external icon, the U.S. Bureau of Labor Statistics indicated that employers reported approximately 2.8 million nonfatal work-related injuries and illnesses to private industry workers. Work-related injuries and illnesses result in substantial human and economic costs for workers, families, employers, and society as a whole. A 2011 publicationexternal icon estimated that the direct and indirect costs of work-related injuries and illnesses exceed $250 billion annually.

Achievements in reducing fatal and nonfatal work-related injuries and illnesses emphasize the importance of continued tracking and monitoring, research, and intervention activities in surveillance. 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 work-related injury, illness, disability, and death caused by hazards in the workplace, the U.S. Centers for Disease Control and Prevention (CDC), NIOSH conducts surveillance to assess the extent and severity of workplace injury, illness, disability, and death to identify workers and occupations at greatest risk, to develop research and prevention priorities, and to measure the effectiveness of prevention activities.

State Role in Occupational Safety and Health Surveillance

NIOSH recognized the key importance of state public health approaches to addressing occupational health problems and began funding pilot surveillance programs in a limited number of state health departments in the 1970’s. State public health agencies have a critical and complementary role in the prevention of occupational injury, illness, disability and death. State agencies apply public health approaches to identify problems, target interventions, and evaluate programs to reduce occupational illness, injury, disability, and death in order to protect the health of working people. These agencies are uniquely positioned to use state-specific data sources and link surveillance findings with intervention outreach activities within their jurisdictions.

NIOSH has funded a variety of approaches to build state capacity OSH, ranging from the development of population-based and case-based surveillance systems, to creating focused public health interventions addressing the occupational safety and health (OSH) needs of high-risk populations such as minorities and teen workers. State programs demonstrate that effective surveillance of occupational injury, illness, disability, and death embraces the concept of “information for action” by ensuring that collection, analysis, interpretation, and dissemination of health data are linked to prevention and control activities. In addition, state surveillance systems and activities provide a vital foundation for several federal surveillance systems and augment others.

NIOSH has used cooperative research agreement funding mechanisms to fund approximately ten state surveillance programs since 2000, and by 2009, the number of funded states increased from 15 to 23. NIOSH provided financial and technical assistance to state health and labor agencies to develop or expand state surveillance program capacity and technical infrastructure. Examples include addition of epidemiologists and other technical staff, training and continuing education, informatics or methods improvements, contracting for specialized statistical and communications expertise, and purchase of statistical software.


The primary purpose of NIOSH’s state surveillance program is to provide financial and technical support to states and other eligible jurisdictions for the development or expansion of an OSH surveillance program. Through this program, NIOSH seeks to strengthen OSH surveillance within states and other eligible jurisdictions that will provide information that will help drive actions to improve the health of workers in the United States.

NIOSH supports the use of existing surveillance data and the collection of new surveillance data to better define the current health of the state’s workforce, target relevant worker populations at risk, develop relevant interventions, and initiate and enhance partnerships within, and beyond, the state’s surveillance community. NIOSH also supports the advancement of state surveillance systems to enable the future use of new or newly emerging electronic surveillance data sources and to participate in the development of the data sources and data exchange methods. NIOSH strongly encourages state surveillance programs to engage directly in activities and initiatives related to the collection, exchange, and use of electronic health data.

States are expected to be innovative in the dissemination and communication of products that they develop. Whenever possible, communication products should inform measurable surveillance data findings and related public health actions that include recommendations for prevention, interventions, policies, and communications that advance the integration of proven health and safety strategies into targeted workplaces by organizations both within and outside of traditional occupational health. A key goal is to build partnerships among surveillance programs and health agencies, and other organizations and stakeholders that engage in occupational safety and health surveillance or can be leveraged to improve surveillance.

NIOSH expects state surveillance programs to:

  • Identify, access, and analyze data that can be used to conduct surveillance of work-related injuries, illnesses, exposures, and fatalities.
  • Use findings for the calculation of incidence and/or prevalence of occupational injuries, illnesses, exposures, and fatalities, including calculation of occupational health indicators (OHIs).
  • Allow recipients to be resourceful and proactive in identifying and accessing untapped data sources for surveillance, which may include creating linkages between data sources.
  • Identify surveillance trends, emerging issues and diseases, high-risk occupations, industries, and worker populations.
  • Establish and address state and NIOSH program priorities for follow-up activities, including more in-depth data surveillance and outreach, prevention, and intervention programs.
  • Develop a broad network of partners who can assist in identifying data appropriate for surveillance and disseminating results.
  • Establish and maintain an advisory committee, or other process(es) to obtain stakeholder input and to identify relevant state-specific issues and priorities for surveillance.
  • Apply current technologies to develop and communicate audience-specific educational materials, outreach, and other resources for optimizing their uptake, adoption, or adaptation for protecting workers.
  • Allow recipients to develop strategic and organizational activities to foster and ensure a competent surveillance program within the state infrastructure.
  • Find ways to foster the integration of occupational safety and health into broader public health goals and objectives (such as infectious and chronic disease).
  • Develop workplace interventions and create links to policy initiatives that may impact worker health and safety in their state.

The current 26 state surveillance portfolio of cooperative agreements funded from 2015-2021 consists of 8 Fundamental, 11 Fundamental-Plus, and 7 Expanded Programs. These 26 states contain about 72% of the civilian labor force and include 18 of the 26 most populated states in the United States. State surveillance programs are managed by 19 state health departments (73%) 2 state Departments of Labor (8%), and 5 bona fide agents (19%), which involve partnerships between state health departments and universities. The portfolio includes approximately 49 projects addressing work-related morbidity and mortality, exposure reduction, and worker populations of special interest, including underserved populations.

NIOSH Sponsored State Occupational Health Safety Surveillance Program 2019

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 27, 2021