Publications and Reports
The publications and resources on this page identify frameworks, solutions, and relevant research for comprehensive programs to improve worker safety, health, and well-being. The resources below include research findings and data that support using an integrated approach, practical solutions to occupational safety and health issues, and discussions on the characteristics of Total Worker Health® strategies.
- Fundamentals of Total Worker Health®Approaches: Essential Elements for Advancing Worker Safety, Health, and Well-being
This workbook prioritizes a hazard-free work environment and outlines the five defining elements of a Total Worker Health (TWH) approach. - The NationalTotal Worker Health® Agenda
This document is intended to define and prioritize occupational safety and health research, practice, and prevention activities related to TWH for 2016-2026. The document includes a variety of strategic goals, intermediate goals, and activity/output goals within the domains of Research, Practice, Policy, and Capacity-Building. - The NIOSH Worker Well-Being Questionnaire (WellBQ)
The questionnaire measures “worker” well-being as a holistic construct rather than simply “workplace” or “work-related” well-being. The NIOSH WellBQ is intended to help researchers, employers, workers, practitioners, and policymakers understand the well-being of workers and target interventions to improve worker well-being, among other applications. - Edited Volume: Total Worker Heath
The edited volume, Total Worker Health, provides an overview of the historical development of the concept and field of TWH. The 17-chapter volume summarizes the theory and research making the case for integrative workplace prevention strategies, highlighting the relationship between occupational risk factors and risks beyond the workplace. - U.S. Surgeon General’s Framework for Workplace Mental Health & Well-being
This framework identifies five essentials that support workplaces as engines of well-being, with each essential based on two human needs. The framework will powerfully stimulate conversations and changes in organizations and workplaces. Worker voice and equity is central to the framework, highlighting the importance of worker engagement.
- Using Total Worker Health Concepts to Address Hearing Health
This document focuses on the application of TWH concepts to promote better hearing health and reduce the risks associated with noise exposure. - Using Total Worker Health Concepts to Reduce Fatigue among Retail Workers
This document describes organizational practices related to scheduling, flexibility, and the work environment that can help address the causes and consequences of fatigue among retail workers. - Using Total Worker Health Concepts to Reduce the Health Risks from Sedentary Work
This document describes organizational practices that can reduce the risks associated with sedentary work and recommends an integrated approach to address sedentary work environments. - Using Total Worker Health Concepts to Enhance Workplace Tobacco Prevention and Control
This document recommends an integrated approach to address personal and workplace safety and health factors and provides recommendations for workplace tobacco prevention and control.
NIOSH funds academic Centers of Excellence for TWH (Centers), which are hubs for TWH-related research and practice. The Centers build the scientific evidence base needed to develop new solutions for complex occupational safety and health issues. Find publications from all of the centers here.
NIOSH researchers regularly work with partners to conduct and author research related to TWH. Below are a few examples of publications resulting from these partnerships that highlight the foundations of TWH approaches and address fundamental concepts of worker safety, health, and well-being.
- The Value of Worker Well-Being
- Education and Training to Build Capacity in Total Worker Health: Proposed Competencies for an Emerging Field
- Toward an Expanded Focus for Occupational Safety and Health: A Commentary
- Expanding the Paradigm of Occupational Safety and Health: A New Framework for Worker Well-Being
- Total Worker Health 2014–2018: The Novel Approach to Worker Safety, Health, and Well-Being Evolves
- Promising and Best Practices in Total Worker Health: Workshop Summary (2014)
- Pathways to Prevention: Total Worker Health—What’s Work Got to Do With It? (2015)
- Integrated Interventions for Improving Total Worker Health: A Panel Report From the National Institutes of Health Pathways to Prevention Workshop: Total Worker Health—What’s Work Got to Do With It? (2016)
- NIOSH Response to the NIH Pathways to Prevention Workshop Recommendations (2016)
- The Effectiveness of Total Worker Health Interventions: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop (2016)
- Total Worker Health: A Promising Approach to a Safer and Healthier Workforce (2016)

Read TWH specific blogs and exchange ideas on various workplace safety and health topics with leading researchers from NIOSH.

Find publications, grant reports, documents, and journal articles relevant to the TWH approach in this searchable biographic database.

Discover tools to help your organization create and sustain a culture aligned with the TWH approach.