were still in important research areas with some connection to improvements in workplace protection.

Impact Score

There is variability in the impacts of RDRP activities on end outcomes or well-accepted intermediate outcomes. Some activities may have large and well-documented impacts, whereas others are smaller and less easily discernable. Again, given the size of the RDRP and the notion that some elements of the RDRP have objectives besides respiratory diseases, the outcome is not surprising. For example, the committee notes that activities related to the development of diagnostic tools for early detection of lung cancer, while relevant to lung cancer in general, have no effect on the program goal associated with work-related respiratory malignancies. The committee recognized that, in terms of assessing measurable impacts, any programmatic efforts of only 10 years’ duration could not be expected to be reflected in changing incidence data for respiratory tract diseases with long latency, most notably respiratory tract malignancies. Thus the absence of data for indicating such impacts was not weighted as a “negative” finding. Where appropriate, however, exposure or other risk factor reductions for disease processes with long latencies were considered. Further, there is no way for NIOSH to quantify specifically the impacts that work on personal respirators and environmental controls have had on reductions in the occurrence of TB and other respiratory infections. However, the activities of the RDRP have clearly played major roles in reducing the occurrence of and mortality from CWP. It also played a major role in reducing the prevalence of latex sensitization as a result of the intervention effort that began with the 1996 NIOSH Alert.

The committee has assigned a score of 4 in its rating of impact, reflecting the committee’s judgment that most of the subprograms within the RDRP have made major contributions to worker health and safety on the basis of end and well-accepted intermediate outcomes. It represents the consensus of the committee on the degree to which the overall program, which is still in its infancy, meets the goals and has had the impacts set out by NIOSH. After much deliberation on how to weigh the assessments of different subprograms, the committee assigned a score of 4 for the program as a whole. Had the committee been given the option of providing non-integer scores, the score for program impact would have been between 4 and 5, based on consensus that the program was clearly better than that called for in a score of 4 but not in sum what the committee would rate a 5.



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