NIOSH Research Rounds

NIOSH Research Rounds is a monthly bulletin of selected research conducted by researchers at NIOSH and NIOSH-funded researchers at other institutions.
Volume 4, Number 12 (June 2019)

Inside NIOSH:
Burden of Silicosis Evaluated among Medicare Beneficiaries

Miner in sulfur mine

A silicosis study among Medicare beneficiaries found most cases occurred among whites, but the highest rates were among North American Natives. Getty Images

The burden of the lung disease silicosis among Medicare beneficiaries has been evaluated by one of the first studies using national medical records to understand the disease’s reach. The study appeared in the American Journal of Industrial Medicineexternal icon.

Silicosis is a preventable, work-related, potentially deadly lung disease caused by breathing in small particles of crystalline silica dust coming from materials such as rock and concrete during activities like mining, construction, and sandblasting. It can develop over years, even after exposure stops, complicating efforts to understand the extent of the disease. In fact, most of the current information on silicosis comes from death records.

In this novel study, investigators looked at health insurance claims and enrollment information for nearly 50 million Medicare beneficiaries age 65 and older from 1999 to 2014. Medicare beneficiaries that met one of the silicosis case definitions were mostly white, but the highest rates were found among North American Natives. The investigators found that annually 12.4 to 24.9 out of 100,000 beneficiaries had indication of silicosis in their medical claims. By state, New Mexico, West Virginia, and Utah had the highest rates of silicosis during the 16 years studied. While new cases of silicosis declined from 2002 to 2014, the number of prevalent cases remained constant from 2005 to 2014. These results are consistent with findings from previous silicosis studies in different populations and show how health insurance claims can inform our understanding of silicosis.

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NIOSH Research Rounds is Brought to You By:
  • John Howard, M.D., Director
  • Christina Spring, Editor in Chief
  • Anne Blank, Managing Editor
  • Donjanea Williams, Contributing Editor
  • Sarah Mitchell, Contributing Editor
  • Jeanette Novakovich, Copy Editor
  • Tonya White, Web Developer
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Slip-resistant Shoes Reduce Slip Injury Workers’ Compensation Claims

slip resistant shoes campaign poster

Food services operations where workers received free highly slip-resistant shoes showed a large reduction in workers’ compensation claims for slip injuries compared to food service operations where workers did not receive the shoes, according to research published in the Scandinavian Journal of Work, Environment & Health.

Slips, trips, and falls are the third-leading cause of U.S. non-fatal work-related injuries involving days away from work across all industries. Almost 80% of these injuries are on the same level, and these injuries are estimated to cost nearly $13 billion in direct workers’ compensation-related costs annually. Laboratory tests have shown that slip-resistant shoes designed with a special tread helped prevent slipping, but studies in actual workplaces were lacking.

To address this research gap, investigators looked at whether a no–cost-to-workers slip-resistant shoe program decreased the risk of slip injuries among food services workers. The shoes provided were 5-star rated for slip-resistance as determined in independent laboratory tests. From August 1, 2009 to December 31, 2013, approximately 17,000 food services workers from 226 school districts, serving students in kindergarten through 12th grade participated in the study. Workers were randomly assigned at the school district level to a group that received no-cost 5-star rated slip-resistant shoes or to a group that did not. Investigators looked specifically at workers’ compensation injury claims caused by slipping on wet or greasy surfaces, the type of incident that the shoes were designed to prevent. School districts filed 67% fewer claims for slip injuries after being provided the slip-resistant shoes, compared to no reduction in claims for slip injuries at the school districts that did not receive the shoes. These results show that providing highly rated slip-resistant shoes can help reduce claims for slip injuries.

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Outside NIOSH:
Breastfeeding Support Varies by Industry for WIC Recipients

Workplace support for breastfeeding varies by industry among New Hampshire mothers served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), according to research published in the International Journal for Environmental Research and Public Healthexternal icon.

Previous studies of mothers served by WIC indicated that they were disproportionately less likely than other mothers to breastfeed. WIC-eligible mothers also are more likely to have low-income jobs, including home or childcare, or service industry positions.

Using a Total Worker Health® framework that focuses on how workplace policies, programs, and practices impact worker well-being, researchers at the University of New Hampshire surveyed 682 mothers enrolled in the state’s WIC program about their breastfeeding practices and their employer’s policies. Most survey respondents were non-Hispanic whites between the ages of 18 to 34, and about half worked either full- or part-time. The survey showed that women in retail had the lowest rates of breastfeeding at 17.6%, compared to 25.2% among women in healthcare. Additionally, the survey showed that mandated breastfeeding policies, including providing a space to pump and supervisory support, were not always in place. These findings underscore the need for more research and transparency across industries to support breastfeeding in the workplace.

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Program Mentors Small Businesses to Improve Health and Safety

With many options available to address worker well-being, how do organizations best ensure the overall safety, health, and well-being of their workers? The NIOSH Total Worker Health (TWH) Program encourages organizational-level changes first and foremost. However, more research is needed to demonstrate the impact of this approach.

NIOSH-funded researchers at the University of Colorado School of Public Health are partnering with small businesses in their state to evaluate how TWH practices, such as increased flexibility, walking meetings, or other workplace policies that encourage worker well-being, affect worker perceptions of their jobsite culture. Though ongoing, the Small+Safe+Well Studyexternal icon has published information on this research in the Occupational Health Scienceexternal icon journal.

For the study, researchers offer a mentoring program to help organizations apply TWH policies and practices and receive healthy workplace certification. Through employee surveys, researchers are measuring the organizations’ health and safety culture. Organizations then receive a Healthy Workplace Report Card, which includes a combined report of employee responses and a score of their TWH programming, so employers can use the results to improve their health and safety. Investigators have also begun creating culturally appropriate, Spanish language versions of the Small+Safe+Well Studyexternal icon surveys, as well as TWH leadership training content and materials. Research continues as the evidence builds for the value of TWH approaches.

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Page last reviewed: June 7, 2019