Total Worker Health in Action: March 2022

Volume 11, Number 1, March 2022

Director’s Buzz


This edition focuses on an essential, and increasingly important component of worker well-being: mental health. This edition’s Total Worker Health® Exclusive sheds light on the links between working conditions and mental health outcomes and provides valuable resources you can access now for your own team’s benefit. We also share a sneak peek into a new initiative to protect health workers’ mental health. Over the next two years, this project will unlock a comprehensive set of messages, calls-to-action, strategies, and resources to address a critical need. While the focus will be on health workers initially, almost every workplace will find applicable content.

A diagram of different colored sticky notes

This issue’s Promising Practice highlights ways NIOSH works to bring TWH approaches to its own workforce through the HealthiestNIOSH program, protecting and promoting work-related mental and physical health at NIOSH. Hear about how HealthiestNIOSH is giving workers a voice in the design of its programs and practices, a critical defining element of any TWH intervention.  You’ll also find important updates from NIOSH, the Centers of Excellence for TWH, and our affiliates. NIOSH and our prolific partners offer hundreds of hours of free content, training, tools, and resources available to you each quarter. If you’ve not tapped in, you’re missing out!

An important update on the upcoming 3rd International Symposium to Advance TWH. This year’s meeting promises to be the most idea-packed and comprehensive ever. The planning panel received a record-breaking 269 abstract submissions, including more than 20 workshop proposals, setting the stage for the most-applied TWH concepts and richest meeting yet. It’s not too late to join the mailing list. You’ll be the first to know all the details as soon as they are released. Sign up and you will receive updates on the agenda, registration, and local area information. Registration opens June 27.

(Insider tip: the event is currently planned as a hybrid-symposium, offering in-person and virtual options for attendance. The in-person component is capacity-limited, and it is highly likely that the event will sell-out. Register early to secure your spot.)

We love hearing from you! For the latest TWH news, research, and events, follow us on Twitter at @NIOSH_TWH, join our NIOSH TWH LinkedIn Group, or send us an email at


L. Casey Chosewood, MD, MPH, Executive Editor

Emily Kirby, Managing Editor

Sarah Mitchell, Associate Editor

Cheryl Hamilton, Copy Editor

Margaret Bertsch, NIOSH Web Developer

Please send your comments and suggestions to us at

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Total Worker Health Exclusive

Total Worker Health Strategies Support Workplace Mental Health

Like all aspects of our lives, both on- and off-the-job, mental health is a crucial part of worker well-being. To comprehensively support well-being, it is critical for organizations and employers to ensure safe working conditions that protect and promote the overall health of their workers, both physical and mental. Mental health includes a person’s psychological, emotional, and social well-being and, because it is a growing challenge for workers and employers, it is a priority area for the NIOSH Total Worker Health (TWH) program.

One major cause of poor work-related mental health is work stress. Harmful physical and emotional responses can happen when the requirements of a job do not match the capabilities, resources, or needs of the worker. Our long-standing research program in work stress at NIOSH shows that mental health worsens with chronic exposure to occupational stress.

3 Person working together to climb a ramp

These types of work-related risks can affect worker mental health:

  • Heavy workloads like long hours of work, inadequate breaks, and heavy physical or emotional demands
  • Unclear or conflicting demands
  • Lack of input in decisions and how work is done
  • Poor communication
  • Lack of support from managers and co-workers
  • Job insecurity
  • Discrimination, harassment, or mistreatment

Resources to Support Worker Mental Health

The NIOSH TWH Program encourages employers to increase their focus and invest more to support worker mental health. We recently hosted the webinar, “How Work Can Impact Mental Health and What Leaders Can Do.” During this event, Dr. Leslie Hammer, from the Oregon Healthy Workforce Center, and Dr. Marie-Anne Rosemberg, from the University of Michigan, presented on current research and promising practices in this area. Their practical approach to change work demands and increase supportive supervision is a meaningful roadmap to immediate improvements.

To assess worker well-being in the workplace, consider using the NIOSH Worker Well-Being Questionnaire (NIOSH WellBQ). This is NIOSH’s latest well-being innovation and represents a 5-year, expert-driven, evidence-based effort to better understand well-being in the context of work. It is the only survey instrument with such a comprehensive focus. The 15-minute, 68-item survey provides an integrated assessment of worker well-being across multiple spheres, including individuals’ quality of working life, circumstances outside of work, and physical and mental health status. The questionnaire measures “worker” well-being as a holistic construct rather than simply “workplace” or “work-related” well-being. You can find resources to help address the issues identified using the results of the NIOSH WellBQ. Examples include resources to improve supervisor and coworker support, tools to build a supportive culture, steps to minimize work-to-personal-life and personal-life-to-work conflicts, and strategies to build workers’ engagement and trust of management.

NIOSH also aims to increase awareness of the role of mental health in worker well-being. To support that, we are working to increase research in this field and to promote workplace practices that support mental health.  Of the recently funded 10 NIOSH Centers of Excellence for TWH, the Johns Hopkins Psychosocial, Organizational, and Environmental (POE) Total Worker Health®Center in Mental Health has an intentional focus on mental health and substance use prevention and treatment among workers. Of many ongoing activities, the Center is developing a valuable Psychosocial, Organizational, Environmental Measurement Tool (POEM) to better understand and respond to needs.

Addressing Health Worker Mental Health

As part of the American Rescue Plan of 2021, NIOSH received Congressional funding to deliver a national awareness and education campaign to safeguard and improve the mental health and well-being of health workers. ​Last fall, NIOSH announced a new initiative to address health worker mental health. The goal is to improve the mental health and well-being of the nation’s health workforce through prevention, awareness, and intervention— and to build a sustainable infrastructure of healthier and less hazardous work for future generations of health workers.

This initiative seeks to prevent and address a range of adverse mental health outcomes related to these challenges, including the risks for work-related stress, burnout, depression, anxiety, substance use disorders, and suicidal behavior. This will be an interdisciplinary and cross-institute effort, with input from partners across the CDC and beyond, including labor, other federal agencies, private organizations, and academic partners.

So far, NIOSH has taken these steps in support of the initiative:

  • Published a request for information about Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health. The request asked for information on existing and potential occupational safety and health interventions, services, and research in progress focused on approaches to preventing stress and improving the mental health and well-being of health workers. Although the request is closed, the comments can still be viewed.
  • Hosted a “Protecting Health Worker Mental Health: A Call-to-Action Webinar” that welcomed Dr. Vivek Murthy, Surgeon General of the United States, and other national experts for a special presentation on health worker mental health. Speakers included NIOSH Director, Dr. John Howard, Dr. Lotte Dyrbye, Co-Director of the Mayo Clinic Program on Physician Well-Being, and Liz Royal from the Service Employees International Union National Nurse Alliance. The webinar covered a range of topics, such as what federal agencies are doing to address this challenge and on-the-ground experiences of health workers.

Drop us a note at if you’d like to follow the progress of this effort or get involved. Stay up to date with this effort on the NIOSH website.

Promising Practice

Worker Safety, Health, and Well-being at NIOSH: HealthiestNIOSH Leads by Example 

Have you ever wondered how NIOSH implements TWH approaches within its own workforce? After all, a defining element of the TWH approach is to demonstrate leadership commitment to worker safety and health at all levels and to give workers a strong voice in the work challenges and issues they care about most. The HealthiestNIOSH Program, sponsored jointly by the Office for TWH and NIOSH’s Human Resources Office, focuses on optimizing the safety, health, and well-being of all those working at NIOSH. HealthiestNIOSH also serves as an applied laboratory for pilot interventions integrating safety and health, helping us to better understand hurdles and barriers of TWH interventions and work design.

HealthiestNIOSH Aims to Improve the Workplace Environment

HealthiestNIOSH (HN) applies a prevention approach consistent with traditional and expanded occupational safety and health principles. HN aims to improve the workplace environment, policies, and programs, and to increase the number of health opportunities available to members of the NIOSH workforce. The program also collaborates with and advises internal and external partners in industry, labor, professional organizations, and academia.

HN serves workers across all NIOSH campuses, reaching them in seven different states and Washington, DC. Working across time zones has unique challenges, so HN uses virtual tools to engage workers in different areas, both now and prior to the pandemic. When many workers transitioned to a telework status, HN adapted in-person programs and services to reach workers wherever they were. Nimble, responsive, current, and solution-oriented are critical themes inherent in all HN planning and program execution.

Pandemic-Responsive Activities to Protect and Promote Mental and Physical Health

A women doing yoga in her own home

The pandemic increased awareness of how important protecting and promoting workers’ mental health and psychological well-being is. To address this complex issue, HN sponsored 13 well-being webinars, delivering 300 training hours to NIOSH workers. The webinars highlighted resources to assist workers and addressed important topics surrounding mental health in the workplace. Webinar titles included “Understanding Mental Health and Depression,” “Mindful Meditation,” and “Parenting During a Pandemic.” HN also sent emails with tips, resources, and other information to help workers navigate challenges in work and life. Topics include “Recognizing and Preventing Seasonal Depression,” “A Holistic Approach to Mental Well-being,” “Benefits of Meditation and Mindfulness,” and “Preventing and Managing Stress.”

Because mental and physical health are equally important components of overall health, HN offered health and well-being coaching and hosted virtual fitness classes and challenges in 2021. Health and well-being coaching engaged workers for six-session commitments. The close relationship between a coach and client facilitates the development of personal, professional, and business goals, as well as a customized plan to achieve those goals. NIOSH also offered more than 40 types of virtual workout classes, hosting 551 classes with certified fitness instructors via Zoom. Over 275 workers participated in three workplace challenges designed to inspire workers to walk 100 miles in 100 days, to get 10,000 steps per day, and to maintain a healthy lifestyle during the holiday season.

Giving Workers a Voice

TWH programs are voluntary and designed using worker participation, giving workers a voice in the conditions of their work and in workplace offerings. HN first conducted an assessment in 2015 that aimed to engage workers, as well as gather feedback on the current programs and amenities available at each NIOSH site. HN has routinely surveyed workers since and, in 2021, HN created and distributed a 31-item assessment focused on topics like well-being, fitness, psychosocial elements, and diversity/inclusion. The assessment was open to all people working at all NIOSH sites. The goal of the assessment was to better understand workers’ preferences surrounding safety, health, and well-being, as they relate to past, present, and future offerings. HN will use data collected from the assessment to plan and develop content and to improve and prioritize programming for all NIOSH locations, in-person and virtually.

The TWH approach emphasizes the role that organizations have in shaping worker safety and health outcomes. We fundamentally believe that workplaces should promote and support worker engagement through program design, focusing on improving the quality of job design and supervision and giving workers a chance for regular input. With these strategies, HN helps improve the safety, health, and well-being of the NIOSH workforce, and in turn, helps NIOSH better serve all workers across the nation.

Spotlight on Opioids in the Workplace

Editor’s note: If you or someone you know needs assistance (in English or Spanish) with mental health concerns and/or substance use disorders, prevention, and recovery, please contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) or visit

NIOSH Joins Effort to Advance Workplace Supported Recovery Programs

NIOSH is excited to join the Office of National Drug Control Policy (ONDCP) and the Domestic Policy Council (DPC) in an interagency working group entitled “Recovery-Ready Workplaces,” to identify and drive policy actions that facilitate employment opportunities for people in or seeking recovery from substance use disorders and promote the adoption of recovery-ready workplace policies. Other participating agencies include the Department of Labor, Department of Justice, U.S. Department of Agriculture, and many others.

The priority of this working group is to expand the adoption of recovery-ready workplace policies across the federal, public, and private sectors. The goal is to help American businesses become more productive and profitable, to create healthier and more resilient workplaces by facilitating help-seeking for employed persons with substance use disorder, and to help Americans in recovery return and contribute to the workforce.

Impairment Recognition and Response Training for Supervisors

Workplace impairment can be a complex and challenging issue. It can negatively affect workplace safety, including the safety and well-being of the impaired worker, co-workers, and the public.   The National Safety Council (NSC) recently briefed NIOSH on a new one-hour learning course, called Impairment Recognition and Response Training for Supervisors. The training aims to help frontline supervisors, safety professionals, and managers recognize and respond to perceived impairment in the workplace.

News from NIOSH

Blog Post: TWH Program Readies NIOSH for Next 50 Years
As NIOSH commemorates its 50th anniversary, the NIOSH TWH Program reflects on its past while focusing on leading the field of occupational safety and health into the future. Learn more on the NIOSH Science Blog.

Free Continuing Education Opportunities for TWH Webinars
Are you a safety professional, physician, pharmacist, veterinarian, or health educator? Do you need continuing education credits? We offer continuing education credits for these and other professions through the TWH webinar series. Learn about important topics like mental health, ageism, and health disparities. Visit the TWH Webinar Series page to find recordings and learn more about how to get continuing education credits.

New Research Agenda From the NIOSH Future of Work Initiative
The NIOSH Future of Work Initiative began in 2019 with a vision to prepare the occupational safety and health ecosystem for a safer, healthier, and more productive future. Dr. Sara Tamers, who leads NIOSH’s research portfolio for TWH, also chairs NIOSH’s Future of Work efforts. The NIOSH Future of Work Initiative Research Agenda sets goals for NIOSH that aim to advance future of work research. The Agenda uses expanded occupational safety and health approaches, reflecting its origins and connections to TWH principles. The Agenda outlines research-focused directions to grow the Initiative. These directions may inform practice, policy, and capacity-building activities, across every NIOSH sector, cross-sector, and core and specialty program. The Agenda frames the most pressing workplace and work issues expected to impact the safety and health of tomorrow’s workforce, across jobs, occupations, and industries using a set of previously developed future of work priority topics and sub-topics.

Recording Available for Protecting the Mental Health of Health Workers Webinar
The recording is available for the NIOSH-hosted webinar “Protecting Health Worker Mental Health: A Call-to-Action.” The webinar aimed to raise awareness about mental health among the health workforce. It included presentations from the U.S. Surgeon General Dr. Vivek Murthy, Dr. Lotte Dyrbye from the Mayo Clinic, and Elizabeth Royal from the Service Employees International Union. NIOSH Director Dr. John Howard also presented on new NIOSH efforts and NIOSH researcher Dr. Tom Cunningham moderated discussions around current challenges, promising practices, and next steps to address working conditions to safeguard the mental health of health workers.

Registration News for the 3rd International Symposium to Advance TWH
Don’t miss updates about the next symposium! This year’s meeting promises to be the most idea-packed and comprehensive ever. The planning panel received a record-breaking number of abstract submissions, with over 260 submissions including more than 20 workshop proposals. Join the mailing list to receive reminders about important deadlines and updates on the agenda, registration, and local area information. Registration will open June 27. Learn more on the symposium website (and check the Director’s Buzz for an insider tip!)

Submit Papers for Special Issue on Technology, Occupational Safety and Health, and Well-being
NIOSH Office of Research Integration and fellow researchers are guest editing a special issue of the International Journal of Environmental Research and Public Health (IJERPH) on the Impact of Technologies on Occupational Health and Well-being and invite you to contribute. The special issue is now open for submission online with a deadline of September 30, 2022. If you are interested in submitting a paper, please email Dr. Sarah Felknor at no later than March 31, 2022, with the authorship, tentative title, and brief description of the topic of your planned paper.


News From the NIOSH Centers of Excellence for TWH

These are just a few of the updates from the NIOSH Centers of Excellence for TWH. To learn more about each of the Centers and their response efforts, visit their websites.

News from NIOSH TWH Affiliates and Partners

Featured Affiliates: Get to Know the NIOSH TWH Affiliates

This new feature was created to introduce our readers to the current NIOSH TWH Affiliates. See how two NIOSH TWH Affiliates responded when we asked about their work. If your organization is a NIOSH TWH Affiliate and is interested in being featured, please email

City of Plano

Learn More About The City of Plano

Center for Social Epidemiology

Learn More About Center for Social Epidemiology

New Hampshire Occupational Health Surveillance Program (OHSP)

Learn more about the New Hampshire Occupational Health Surveillance Program (OHSP)

Affiliate Updates

National Firefighter Cancer Symposium
The Firefighter Cancer Initiative and the Miami Occupational Research Group hosted the 2022 National Firefighter Cancer Symposium in February. The annual symposium brings together members from the scientific, academic, firefighting, government, and labor/management communities to support the reduction of cancer risk in the U.S. fire service.

Podcast on Emerging Priorities
In case you missed it, you can learn about emerging priorities for the TWH program in a recent podcast from the St. Louis Area Business Health Coalition. The podcast features the NIOSH TWH program’s Coordinator for Partnership and Opportunity Development, Chia-Chia Chang.

Publications on Workplace Health  
HealthPartners recently published two articles highlighting issues relevant to workplace health. Learn more in Pragmatic Evaluation of a Health System-Based Employee Weight Management Program and  Addressing Sedentary Behavior At The Worksite: Is It Time for Practice-Guided and Systems-Informed Research?

Survey: Measure Sources of Stress in the Workplace
The online Healthy Work Survey is now available from the Center for Social Epidemiology and the Healthy Work Campaign. It is a free, anonymous tool that measures sources of stress in the workplace that can impact the health and well-being of workers. The survey can be used by individuals or organizations (employers or unions/worker advocates) as part of a TWH approach to assess the levels of common work stressors.

To learn more about the TWH Affiliate program, visit

New Publications and Resources

Conferences, Webinars, and Training in Support of NIOSH Total Worker Health


2 – CHWE will host “You Belong Here: A Total Worker Health Approach to Inclusive Engagement at Your Workplace” at 11 a.m. (MT). Join Health Links™, along with national and local experts, to learn more about how to foster a workplace culture of belonging, inclusion, and support.

9 – Join the webinar Greater Lawndale Lotería – How A Worker Justice Themed Card Game is Implemented As An Educational Tool at 12 pm CST. Lotería is a Spanish word meaning “lottery.” The webinar will detail the design and implementation of Greater Lawndale Lotería, a traditional game of chance, akin to bingo, which can be used as an educational tool.

16 – Join the webinar titled “In A Year’s Work™ – Educational game and focus group opportunityat 12 p.m. (CST). In a Year’s Work™ is an educational game that demonstrates how different workers within the same organization experience the social determinants of health.

16 – Register for the Total Worker Health Trends: Expert Webinar Series onAddressing Worker Mental Health: The Healthy Work Campaign” with Dr. Marnie Dobson at 1 p.m. (ET).

31 – The Healthier Workforce Center is co-sponsoring the Occupational Health Symposium on March 31 and April 1 in Coralville, Iowa. This symposium will address the ever-changing nature of work and the implications of these changes for the health, safety, and well-being of workers.


13-15 – Chia-Chia Chang, Coordinator for Partnership and New Opportunity Development in the Office for TWH, will present on the NIOSH Worker Well-Being Questionnaire (NIOSH WellBQ) at the Art & Science of Health Promotion Conference.

14 – The Mountain & Plains Education and Research Center (MAP ERC) 14th Annual Research Day Symposium will bring together environmental and occupational health students, trainees from the MAP ERC, and local professionals to celebrate student research in environmental and occupational health. The event will feature presentations from participants in the Certificate in TWH program.

20 – Join the webinar titled Work-Scheduling Practices and Impacts on Workers’ Well-being at 12 p.m. (CST). Alison Dickson will share her recent research around adverse consequences of insecure work hours and the ability of fair workweek policies to improve worker well-being.

21 – The Nebraska Safety Council Conference and Trade Show will be held April 21 in Lincoln, Nebraska. Educational sessions will cover a variety of safety, wellness, leadership, environmental, and human resource topics.

23 – Join the TWH team and many of our partners at the American Industrial Hygiene Conference & Exposition (AIHce). Casey Chosewood, Director of the Office for TWH, and Chia-Chia Chang and will present.


10–12 – The Director of the Center for Work, Health, & Well-being, Glorian Sorensen, will lecture during a three-day course entitled Designing, Implementing, and Evaluating Organizational Interventions taking place in Reykjavik, Iceland. The course will focus on how we can develop, implement, and evaluate organizational interventions to improve working conditions and employee health and wellbeing through changing the way work is organized, designed, and managed.

17-20 – Work Health and Well-being: Achieving Worker HealthCenter for Worker Health & Well-being investigators and researchers will be teaching this Harvard T.H. Chan School of Public Health Executive and Continuing Professional Education course. Participants will gain the skills needed to implement policies, programs, and practices focused on working conditions that impact both worker and employer safety, health, and well-being outcomes. Participants will also learn how to make the business case for improving employee health. For more information, go to: 

18 – Register for The State of Workplace Mental Health: 2022” at 11 am MT. Join Health Links™, along with national and local experts, and discover how to build a workplace culture that supports the mental health of all employees.

Save the Date

June 3

The 2022 Spring Symposium “From the Great Resignation to the Great Reconfiguration: Connecting Research and Practice” takes place from 9 a.m.–3 p.m. (PT). This full-day symposium will identify the key drivers behind the challenges employers are experiencing as they try to attract and retain qualified employees. Most of the day will be spent focusing on successful strategies that organizations can use to recruit and retain employees. The significant well-being challenges felt by many American workers will also be addressed.

September 8–9
The National Association of Worksite Health Centers 10th Annual Forum will be held in Nashville, Tennessee. The event will have these formal and roundtable sessions: The direction of employer centers in post-COVID-19 world; Planning and design of worksite health centers; Operations, staffing and management of worksite health centers; Legal and regulatory aspects of worksite health centers; The impact of COVID-19 on center services; Measuring the health center performance; Increasing utilization and engagement; Pharmacy services; and Digital services.

October 11–14

The Third International Symposium to Advance TWH will be hosted virtually and in-person at the National Institutes of Health Natcher Conference Center in Bethesda, Maryland. Registration opens June 27.

Find more events on the NIOSH Conferences, Meetings, Webinars, and Events webpage.

Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. In addition, citations to websites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these websites. All web addresses referenced in this document were accessible as of the publication date.