younger workers (those under 18 years of age) also play important roles in the workforce. Individuals in these populations have risk factors that may need to be addressed differently from those risk factors among individuals in the general population. For example, are older workers more adversely affected by shiftwork? The U.S. workplace itself has also evolved as the U.S. economy has moved rapidly from a manufacturing-based to a service-based economy and is now developing into one centered on information and information technology. In addition, there have been profound changes in the way in which work is organized. Distributed work arrangements, flexible matrix- and team-based organizational structures, and nonstandard work arrangements have become commonplace, challenging the competencies of current occupational safety and health professionals.
In terms of delivery of OSH services, industry-supplied OSH resources may no longer play as large a role as they once did. As companies downsize, OSH staff may be outsourced or eliminated altogether. The OSH role may be assumed by other staff who do not have training in OSH or by a person with training in a combination of disciplines. Other important changes are occurring in health care delivery generally, with an increased emphasis on managed care and other means of reducing costs. The evolving role of the occupational physician has not been explored in this new delivery system, nor have the roles of primary care physicians, nurse practitioners, or other health professionals who may be treating workers.
From a regulatory standpoint, OSHA has added standards over the years that require “qualified,” “designated,” or “competent” persons to ensure enforcement at the work site, but there has been no agreement on the training that will enable personnel to meet these designations. OSHA also mandates training of workers in more than 100 standards but does not speak to the quantity, quality, or efficacy of that training. Few if any standards call for training of employers or managers responsible for workplace safety and health.
Because of these workforce, workplace, and OSH care changes, NIOSH’s traditional focus on training of industrial hygienists, occupational physicians, occupational nurses, and safety professionals may no longer be sufficient. Evolving demands on the OSH professional in meeting the challenges of the new workplace may call for a much broader perspective than that taken in the past, including an expanded emphasis on such fields as epidemiology, ergonomics, health communication, the behavioral sciences, health care cost control, and management.
There is thus an urgent need to examine the numerous factors changing the modern workplace, derive the implications of these trends for OSH, and make corresponding changes in the education and training of