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Reducing the Burden of Injury: Advancing Prevention and Treatment
shortcoming, however, is that NORA's 21 priorities are themselves not prioritized. NORA's widespread support appears to depend on these key procedural elements: a participatory and consensus-building approach to planning in partnership with stakeholders; criteria for setting priorities; refining of priorities as circumstances change; and plans to evaluate the impact of priority setting. The inclusion of other federal agencies, such as NIH and OSHA, as partners in the priority-setting process is another important milestone. NORA gives OSHA a formal opportunity to fulfill its regulatory needs by influencing the research agenda of a sister agency. Through research planning, NIOSH remains responsive to regulatory demands, while preserving its scientific integrity and commitment to high-quality science.
Congress recognized the importance of NORA by appropriating an additional $5 million to NIOSH in FY 1998 for implementation of research priorities relating to occupational dermatitis, musculoskeletal disorders, and asthma. NIOSH leveraged these resources with an additional $3 million from several NIH institutes to issue a joint announcement seeking research proposals from the extramural community (NIOSH, 1998a). The total allotment of $8 million represents the largest-ever single infusion of research funds for investigator-initiated occupational safety and health research (NIOSH Budget Office, personal communication, 1998).
Traumatic injury research priorities recently developed by the multidisciplinary NORA team assigned to this topic also warrant special consideration by Congress. The NORA team specified detailed research priorities under the general topics of surveillance, analytic injury research, prevention and control, communication and technology transfer, and evaluation (NIOSH, 1998b). Traumatic occupational injuries, which received only about 8 percent of NIOSH's budget, have not attained sufficient priority in light of the magnitude and costs of occupational injuries. A recent study found that the mortality, morbidity, and costs of occupational injuries considerably overshadowed those of occupational diseases (Leigh et al., 1997). The study estimated that 6,500 deaths and 13.2 million occupational injuries occur annually at cost of $145 billion, compared with an annual cost of $26 million for occupational diseases. Therefore, more funding should be accorded to research on traumatic injury in the workplace.
The committee recommends that NIOSH, working in collaboration with other federal partners, implement the NORA research priorities for traumatic and other injury-related occupational injuries, and give higher priority to injury research.
NIOSH also deserves credit for heightened public awareness of occupational safety and health. It initiated an improved dissemination strategy for publications and other educational materials. The strategy targets materials to appropriate audiences, especially employers and workers at risk. For example, NIOSH's Alert of September 1994, Preventing Injuries and Deaths of Fire