Traumatic Injury Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health (2009)

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B Methods and Information Gathering This appendix briefly describes sources of information used by the committee to perform its assessment of the National Institute for Occupational Safety and Health (NIOSH) Traumatic Injury (TI) Research Program’s relevance and impact. Sources of information included an evidence package prepared by TI Research Pro- gram staff, stakeholder comment, and presentations by TI Research Program staff before the committee. A brief overview of the methods by which the committee evaluated information can be found in Chapter 1 of this report. THE TI RESEARCH PROGRAM EVIDENCE PACKAGE Information about the TI Research Program came in the form of an evidence package prepared by TI Research Program staff. Each committee member was given a copy of the evidence package prior to the committee’s first meeting. The evidence package included overviews of NIOSH and the TI Research Program as well as in-depth descriptions of the TI Research Program’s work in each of the goal and subgoal areas. For each subgoal, there was an issue statement describing the research need that the TI Research Program is addressing, the approach (TI Research Program and extramural grantee overall strategy and research activities), outputs and transfers, and outcomes. For most subgoals there was a description of  The evidence package is available for viewing on the NIOSH Web site at http://www.cdc.gov/ niosh/nas/traumainj/. 182 

A p p e n d i x B 183 external factors impacting the program and an overview of activities planned to extend research in the particular area. A draft of the TI Research Program’s “Stra- tegic Goals for the Future” was also included. The evidence package included appendixes for each of the following: support- ing evidence by goal or subgoal; TI intramural and extramural projects; TI man- agement and research staff; TI informational resources; TI laboratory facilities and specialized equipment; TI partners and stakeholders; TI-sponsored or supported workshops and conferences; previous TI Program evaluations; and citation and dissemination data for TI output. STAKEHOLDER COMMENT NIOSH provided the Institute of Medicine (IOM) project staff with the names and contact information of 30 stakeholders identified as having an interest in occupational injury research and prevention. This list included representatives of associations, academia, product development, and federal and local govern- ment agencies. The list also included at least one representative for each of the eight traumatic injury research program goal areas (with the exception of motor vehicles), as well as four people identified as having a general interest in the TI Research Program. Prior to the committee’s final meeting, an e-mail inviting the aforementioned stakeholders to comment on the TI Research Program was prepared and sent to stakeholders by project staff on behalf of the committee. The e-mail explained the IOM committee’s statement of task and provided an outline of the TI Research Program’s goals and subgoals. Recipients were invited to submit comments on NIOSH’s work in any or all of the goal areas. Additionally, recipients were encour- aged to share the e-mail with other individuals or organizations with an interest in NIOSH’s traumatic injury research. Stakeholders could submit comments by e-mail, fax, or a Web form. Due to low response to the first e-mail, IOM project staff sent a follow-up e- mail after the committee’s final meeting, reminding stakeholders of the opportunity to submit comments. At the conclusion of the approximately 6-week comment period, the commit- tee had received submissions from representatives of Femco, Inc. (a manufacturer of vehicle rollover protection devices); the National Truck Equipment Association (NTEA), Ambulance Manufacturers Division; Skyjack, Inc. (a manufacturer of fall protection equipment); the American Society of Safety Engineers (ASSE); and the Alaska Marine Safety Education Association (AMSEA). Those comments were then distributed to committee members for consideration in their evaluation of the TI Research Program. The AMSEA representative stated that NIOSH’s research 

184 T r a u m a t ic I n j u r y R e s e a rc h at N I OSH on Alaska’s high-risk industries covers most areas of exposure in these occupations and did not provide any further comments. Comments from representatives of the other four organizations are summarized in Box B-1. PRESENTATIONS BY TI RESEARCH PROGRAM STAFF BEFORE THE COMMITTEE There were three in-person committee meetings, the first two of which in- cluded open sessions (see agendas below). The open portion of the committee’s first meeting consisted of presentations by TI Research Program staff on the TI Research Program and each of its eight goals. A brief question-and-answer session followed each presentation. During the open portion of the committee’s second meeting, NIOSH staff gave presentations on NIOSH goal setting and prioritization as well as uses of surveillance data. Open Session Agendas for First and Second Committee Meetings Evaluation Committee Meeting One Presentations by TI Program Staff—March 28, 2007 Charge to the Committee—NIOSH Overview Lewis Wade, Ph.D. NIOSH Senior Science Advisor Overview of the Traumatic Injury Program Nancy Stout, Ed.D. Director, NIOSH Division of Safety Research Program Manager, NIOSH Traumatic Injury Program Reduce Injuries and Fatalities in the Transportation Sector Stephanie Pratt, M.A. Epidemiologist, NIOSH Division of Safety Research Program Coordinator; Transportation, Warehousing, Utilities Sector Program Reduce Injuries and Fatalities from Falls from Elevations Hongwei Hsiao, Ph.D. Chief, Protective Technology Branch NIOSH Division of Safety Research 

A p p e n d i x B 185 Reduce Injuries and Fatalities Due to Workplace Violence Harlan Amandus, Ph.D. Chief, Analysis and Field Evaluations Branch NIOSH Division of Safety Research Reduce Injuries and Fatalities Due to Machines John Myers, M.S.F. Health Statistician, NIOSH Division of Safety Research Reduce Acute Back Injuries James Collins, Ph.D. Associate Director for Science NIOSH Division of Safety Research Reduce Injuries and Fatalities Among Workers in Alaska Bradley Husberg, M.S.P.H. Epidemiologist, NIOSH Alaska Field Station Reduce Injuries and Fatalities to Emergency Responders Timothy Pizatella, M.S. Deputy Director, NIOSH Division of Safety Research Reduce Injuries and Fatalities to Working Youth Dawn Castillo, M.P.H. Chief, Surveillance and Field Investigations Branch NIOSH Division of Safety Research Questions and Discussion Evaluation Committee Meeting Two Presentations by TI Program Staff—May 31, 2007 Goal Setting and Prioritization Nancy Stout, Ed.D. Director, NIOSH Division of Safety Research Program Manager, NIOSH Traumatic Injury Program 

186 T r a u m a t ic I n j u r y R e s e a rc h at N I OSH BOX B-1 Stakeholder Comments on NIOSH and the TI Research Program Femco, Inc.—Rollovers on Tractors and Zero-Turn Radius Mowers • Tractor and zero-turn radius mower accident reports are not widely available. Publi- cation and dissemination of accident reports is needed to educate potential rollover protection structure (ROPS) users of the dangers of operating tractors and zero-turn radius mowers without ROPS. NTEA, Ambulance Manufacturers Division—Improving Protection for Ambulance Workers in Patient Compartments • Results of research to improve protection for ambulance workers in patient compart- ments (subgoal 7.1) should be officiated by the National Highway Traffic Safety Ad- ministration (NHTSA), as it relates to occupant protection in new motor vehicles and therefore falls under NHTSA’s responsibility and authority. Skyjack, Inc.—Fall Protection and Injuries and Fatalities Associated with Machinery • Many injuries and fatalities involving the use of aerial lifts could be prevented through proper training of aerial lift operators, which would include coverage of aerial lift haz- ards, standards and regulations, and safe-use principles. Trainers should be certified compliant to the International Standardization Organization’s standard 18878 of 2004,a which outlines methods to prepare training materials and to administer training to operators of mobile elevating work platforms. • There has been and continues to be debate within the aerial lift industry with regard to proper use of fall protection on aerial lifts, in particular on scissor lifts and small personnel units.  Research is needed to determine what fall protection uses are ap- propriate and safe for various types of aerial lifts. • OSHA has fallen behind the industry with regard to maintaining regulations for aerial lift equipment.  Many of the references within the regulations are outdated, and not specific to this equipment. Clearer, more focused regulations would eliminate confu- sion in the workplace, and ensure that employers are aware that appropriate training is required to operate these units. ASSE • Professionalism in Safety, Health, and Environmental (SH&E) Practice N  IOSH should support research to give both business and the safety and health community a better understanding of the training needed for SH&E professionals to 

A p p e n d i x B 187 BOX B-1 (continued) function appropriately as managers of workplace risks. Also, NIOSH should work with organizations offering safety certifications (e.g., the Board of Certified Safety Profes- sionals, the American Board of Industrial Hygiene, and the Institute of Hazardous Material Management) to help determine how to apply what is known about safety and health professionals’ competencies so that a comprehensive understanding of tasks and capabilities throughout the industry can be achieved. This same research can help examine other professional issues, such as: – he appropriateness of SH&E education and training and how individuals enter T and advance in the SH&E profession; – he extent to which different SH&E professional segments have converged across T traditional job roles; – he role of technology in SH&E practice to advance effectiveness of SH&E T management; – he distribution of SH&E practitioners; and T – ays to encourage more individuals to achieve the highest level of safety educa- W tion, as well as formulate Ph.D. programs that will prepare individuals to meet future SH&E needs. • NIOSH Involvement in Consensus Standards Process I ncreased NIOSH involvement in the national consensus standards process could help ensure that NIOSH research findings become operational in the field and could also bring NIOSH closer to safety and health practitioners and the challenges they face in advancing safety and health. • Safety and Health Management Research N  IOSH should sponsor more research that examines the role that broad safety and health management plays in the corporate and program structures of organizations. Greater commitment to safety and health at the highest management levels offers the best opportunity to reduce injuries, illnesses, and fatalities. Research is also needed to better understand how to make the business case for safety. NIOSH should be involved in bringing forth definitive, data-driven studies to help set a value on making a case for the workplace safety and health. aISO 18878: 2004—Mobile elevating work platforms—Operator (driver) training. 

188 T r a u m a t ic I n j u r y R e s e a rc h at N I OSH ACKNOWLEDGMENTS The committee would like to thank the NIOSH staff for assembling the evi- dence package used by the committee for its evaluation. The committee would also like to thank the NIOSH staff, including Dr. Harlan Amandus, Ms. Dawn Castillo, Dr. James Collins, Dr. Honwei Hsiao, Mr. Bradley Husberg, Mr. John Myers, Mr. Timothy Pizatella, Ms. Stephanie Pratt, Dr. Nancy Stout, and Dr. Lewis Wade for their presentations and responses to questions from the committee and IOM staff at the committee’s meetings. The committee also thanks Dr. Raymond Sinclair who served as the liaison between the committee and NIOSH. The committee especially extends its gratitude to Dr. Nancy Stout, who acted as the point of contact for the TI Research Program, and made time to respond to committee questions outside of meetings as well as to provide to the committee additional information not included in the evidence package. The committee would also like to thank those who responded to the com- mittee’s request for stakeholder comment on the NIOSH TI Research Program. These were Mr. Brad Boehler of Skyjack, Inc., Ms. Kelly Comer of Femco, Inc., Mr. Jerry Dzugan of AMSEA, Mr. Steve Spata of NTEA, and Mr. Michael Thompson of ASSE. The committee thanks the National Academies staff who provided assistance with the review, publication, and dissemination of this manuscript, including Lara Andersen, Clyde Behney, Bronwyn Schrecker Jamrok, Abbey Meltzer, Elisabeth Reese, and Jackie Turner. The committee also thanks for their guidance National Academies staff Andrew Pope, director of the IOM Board on Health Sciences Policy, as well as Evan Douple, Cathy Liverman, and Sammantha Magsino, staff to the Committee for the Review of NIOSH Research Programs. The committee thanks as well Rose Marie Martinez, director of the Board on Population Health, and Hope Hare for their support of this important project. The committee particularly thanks the study staff, Morgan Ford, Kathleen Stratton, and Kristina Van Doren Shulkin.