ments, among others, have become commonplace, challenging the traditional model for the provision of OSH programs. Important changes are also occurring in the health care system, most notably the increased emphasis on managed care and other means of reducing costs. As yet unexplored are the implications of this new care delivery system for occupational physicians, as well as possible changes in the roles of primary care physicians, nurse practitioners, and physician assistants who may be treating workers.

From a regulatory standpoint, OSHA has added job safety standards over the years that include requirements that “qualified,” “designated,” or “competent” persons ensure their enforcement at the work site, but there has been no agreement as to what type of training might enable such personnel to meet these requirements. OSHA also mandates training of workers in more than 100 of its standards, but it does not speak to the quantity, quality, or efficacy of that training. Few if any standards call for the training of employers or of managers responsible for workplace safety and health.

Given the widespread changes affecting nearly every aspect of workplace safety and health, NIOSH, with support from OSHA, the National Institute of Environmental Health Science (NIEHS), and the U.S. Department of Veterans Affairs, asked the Institute of Medicine to characterize and assess the current U.S. workforce and work environment and forecast the demand and need for, and supply of, qualified OSH professionals. The goal of the assessment was to identify gaps in OSH training programs that could be filled by either public or private programs and to identify the critical curricula and skills needed to meet these evolving occupational safety and health concerns.


The charge to the committee was fourfold, calling for analyses of both the adequacy of the current OSH workforce and training and adjustments that might be required in the future because of changes in the workforce, the workplace, the organization of work, and health care delivery.

  1. Assess the demand and need for OSH professionals as well as the adequacy of the OSH professional supply by sampling members of the OSH community (industry, small business, labor, academia, professional organizations, health providers, contract services, and governmental agencies). This assessment would determine the number and type of personnel currently employed; their professional duties, skills, abilities, and knowledge; and shortfalls in these categories.

  2. Analyze changes in the workforce and work environment that are

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