A Smarter National
Safety and Health
in the 21st Century
Committee on Developing a Smarter National Surveillance System for
Occupational Safety and Health in the 21st Century
Board on Agriculture and Natural Resources
Division on Earth and Life Studies
Committee on National Statistics
Division of Behavioral and Social Sciences and Education
Board on Health Sciences Policy
Health and Medicine Division
A Consensus Study Report of
THE NATIONAL ACADEMIES PRESS
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This activity was supported by Grant 200-2011-38807 from the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Grant HHSP233201400020B from the Department of Labor, Bureau of Labor Statistics, and Grant DOL-OPS-16-P-000193 from Department of Labor, Occupational Safety and Health Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-46299-0
International Standard Book Number-10: 0-309-46299-1
Digital Object Identifier: https://doi.org/10.17226/24835
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Copyright 2018 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24835.
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COMMITTEE ON DEVELOPING A SMARTER NATIONAL SURVEILLANCE SYSTEM FOR OCCUPATIONAL SAFETY AND HEALTH IN THE 21ST CENTURY
EDWARD H. SHORTLIFFE, NAM,1 Arizona State University, Tempe
DAVID K. BONAUTO, Washington State Department of Labor and Industries, Tumwater
DAVID L. BUCKERIDGE, McGill University, Montreal, Quebec, Canada
STEVEN B. COHEN, RTI International, Washington, DC
LETITIA K. DAVIS, Massachusetts Department of Public Health, Boston
GERALD F. KOMINSKI, University of California, Los Angeles
SCOTT A. MUGNO, FedEx Ground, Moon Township, PA
KENNETH D. ROSENMAN, Michigan State University, East Lansing
NOAH S. SEIXAS, University of Washington School of Public Health, Seattle
MARGARET M. SEMINARIO, AFL-CIO, Washington, DC
GLENN M. SHOR, California Department of Industrial Relations, Oakland
DAVID H. WEGMAN, University of Massachusetts Lowell
PEGGY TSAI YIH, Study Director, Board on Agriculture and Natural Resources
JENNA BRISCOE, Research Assistant, Board on Agriculture and Natural Resources
CATHY LIVERMAN, Scholar, Board on Health Sciences Policy
MICHAEL COHEN, Senior Program Officer, Committee on National Statistics
YASMIN ROMITTI, Research Associate, Board on Atmospheric Sciences and Climate, Board on Earth Sciences and Resources
ROBIN SCHOEN, Director, Board on Agriculture and Natural Resources
1 National Academy of Medicine.
BOARD ON AGRICULTURE AND NATURAL RESOURCES
CHARLES W. RICE, Kansas State University, Manhattan
SHANE C. BURGESS, University of Arizona, Tucson
SUSAN CAPALBO, Oregon State University, Corvallis
GAIL CZARNECKI-MAULDEN, Nestle Purina PetCare, St. Louis, MO
GEBISA EJETA, Purdue University, West Lafayette, IN
JAMES S. FAMIGLIETTI, California Institute of Technology, Pasadena
FRED GOULD, NAS,1 North Carolina State University, Raleigh
DOUGLAS B. JACKSON-SMITH, Ohio State University, Wooster
MOLLY M. JAHN, University of Wisconsin–Madison
ROBBIN S. JOHNSON, Cargill Foundation, Wayzata, MN
JAMES W. JONES, NAE,2 University of Florida, Gainesville
A.G. KAWAMURA, Solutions from the Land, Washington, DC
STEPHEN S. KELLEY, North Carolina State University, Raleigh
JULIA L. KORNEGAY, North Carolina State University, Raleigh
JAN E. LEACH, Colorado State University, Fort Collins
JILL J. MCCLUSKEY, Washington State University, Richland
KAREN I. PLAUT, Purdue University, West Lafayette, IN
JIM E. RIVIERE, NAM,3 Kansas State University, Manhattan
ROBIN A. SCHOEN, Director
1 National Academy of Sciences.
2 National Academy of Engineering.
3 National Academy of Medicine.
COMMITTEE ON NATIONAL STATISTICS
FRANCINE BLAU, Cornell University, Ithaca, NY
MARY ELLEN BOCK, Purdue University, West Lafayette, IN
ANNE E. CASE, NAM,2 Princeton University, Princeton, NJ
MICHAEL CHERNEW, NAM,2 Harvard Medical School, Boston, MA
JANET CURRIE, NAM,2 Princeton University, Princeton, NJ
DONALD A. DILLMAN, Washington State University, Pullman
CONSTANTINE GATSONIS, Brown University, Providence, RI
JAMES S. HOUSE, NAM,2 University of Michigan, Ann Arbor
THOMAS L. MESENBOURG, Retired; formerly, U.S. Census Bureau
SARAH M. NUSSER, Iowa State University, Ames
COLM A. O’MUIRCHEARTAIGH, University of Chicago, IL
JEROME P. REITER, Duke University, Durham, NC
ROBERTO RIGOBON, Massachusetts Institute of Technology, Cambridge
JUDITH A. SELTZER, University of California, Los Angeles
EDWARD H. SHORTLIFFE, NAM,2 Arizona State University, Tempe
BRIAN A. HARRIS-KOJETIN, Director
1 National Academy of Sciences.
2 National Academy of Medicine.
BOARD ON HEALTH SCIENCES POLICY
JEFFREY KAHN, Johns Hopkins University, Baltimore, MD
WYLIE BURKE, NAM,1 University of Washington, Seattle
R. A. CHARO, NAM,1 University of Wisconsin–Madison
LINDA H. CLEVER, NAM,1 California Pacific Medical Center, San Francisco
BERNARD A. HARRIS, Jr., Vesalius Ventures, Houston, TX
MARTHA N. HILL, NAM,1 Johns Hopkins University School of Nursing, Baltimore, MD
STEVEN E. HYMAN, NAM,1 Broad Institute, Cambridge, MA
ALAN M. JETTE, NAM,1 Boston University School of Public Health, MA
PATRICIA A. KING, NAM,1 Georgetown University Law Center, Washington, DC
STORY C. LANDIS, NAM,1 National Institute of Neurological Disorders and Stroke, Bethesda, MD
HARRY T. ORR, NAM,1 University of Minnesota, Minneapolis
UMAIR A. SHAH, Harris County Public Health and Environmental Services, Houston, TX
ROBYN STONE, NAM,1 LeadingAge, Washington, DC
SHARON TERRY, Genetic Alliance, Washington, DC
ANDREW POPE, Director
1 National Academy of Medicine.
2 National Academy of Sciences.
Many threats to health and well-being occur in the workplace. Understanding those risks to prevent injury, illness, or even fatal incidents is an important function of society. We expect interested parties to measure the frequency of incidents, to determine causes when possible, and to offer preventive measures to stakeholders so that the work environment becomes safer and healthier over time. This all needs to occur in the context of a changing workforce and the evolution of the nature of work, suggesting that new kinds of threats to health and well-being can occur, even as others are being optimally managed or are becoming less pertinent as jobs or industries fade away and are replaced by others. In the United States, both the federal and state governments are heavily involved in monitoring occupational health and safety and developing policies or interventions intended to mitigate work-related injuries and disease. At the federal level, principal agencies involved with such work include the Bureau of Labor Statistics (BLS), the National Institute for Occupational Safety and Health (NIOSH, a division of the Centers for Disease Control and Prevention), and the Occupational Safety and Health Administration (OSHA).
Many of the challenges faced by these agencies relate to gathering the information necessary to measure and assess the frequency of workplace-related injuries and illnesses so that suitable policies and interventions can be proposed. In 1987, the agencies sought the advice of the National Research Council regarding surveillance for occupational safety and health (OSH). The resulting report, Counting Injuries and Illnesses in the Workplace: Proposals for a Better System, provided seminal guidance on how to
organize and enhance the U.S. programs for OSH surveillance. In the subsequent 30 years, despite many efforts developed in response to the 1987 recommendations, both the technology for surveillance and the nature of work have evolved considerably.
In the intervening years, the National Academies of Sciences, Engineering, and Medicine have been involved in many workshops, studies, and reports that have touched on issues related to occupational safety and health. For example, from 2006-2009, NIOSH requested that the National Academies undertake programmatic reviews of some NIOSH research programs. The need for better surveillance was a theme that emerged from each of those reviews. In 2014, sequestration forced federal agencies to re-examine their programs as they were asked to address their agency’s mission more effectively but with fewer resources. More recently, the director of NIOSH again approached the National Academies to assist them and other agencies to come up with creative solutions across many categories of occupation for surveillance and monitoring, and to be able to do so in a “smarter” and cost-effective manner.
THE COMMITTEE AND ITS CHARGE
To obtain forward-looking advice, NIOSH, BLS, and OSHA jointly asked the National Academies to conduct a study in response to the need for a more coordinated, cost-effective set of approaches for occupational safety and health surveillance in the United States. Our study committee has addressed this task, gathering information about the strengths and limitations of existing national and state approaches, reviewing a variety of methodologies and technologies that might be applied usefully and cost-effectively. The resulting report is a product of more than a year of deliberations, offering the consensus advice of a diverse set of individuals who have studied the issues carefully and learned a great deal in the process. We have formulated a future vision that is intended to assist all stakeholders, including the agencies, as they seek to improve occupational safety and health in the coming years.
Some of the committee members are career professionals who have worked in the area of occupational safety and health, both at state and national levels. Others brought complementary skill sets that were pertinent to the committee’s charge: epidemiology, occupational medicine, survey methodologies, biomedical informatics, data analytics, economics, cost-benefit analysis, and workplace organization and management. I was honored to help lead this diverse group of talented professionals, all of whom contributed enthusiastically and tirelessly to the discussions, deliberations, and the final report. We quickly realized that the topic is very large
and complex, with nuances that many of us had not anticipated when we joined the study group. Our knowledge of the topic was broadened, in the first three meetings and several conference calls during the early months, by informative sessions with invited experts who helped us to address the task. Large portions of the early meetings were open, with members of the public invited to attend and to provide comments.
We turned, for our final two meetings, to private deliberations, reviewing all that we had learned in order to develop a shared vision of what was possible and seeking to offer recommendations that were responsive to the committee’s charge and were actionable. Our task was further influenced by a change in government during the study period, leading to uncertainties about future budgets and focus for the pertinent federal agencies.
This report benefited from the combined talents of many people, including those who were directly associated with the project and many who were not. First, thanks are due to members of the committee itself, all of whom maintained a high level of enthusiasm, energy, and dedication over the course of the project. Committee members found time for five project meetings, for multiple conference calls, and for drafting portions of the text despite their many other responsibilities and commitments.
Many other people volunteered their time and expertise to help the committee to understand better the ways in which OSH surveillance might be strengthened and modernized in ways that would be acceptable, and even inspirational, for all stakeholders. The information gathered during these interactions proved invaluable to the committee’s deliberations and forms the backbone of this report. Those who provided us with briefings are summarized in Appendix C to the report. We thank them all for their important contributions.
The committee members, many of whom have served on previous study groups, stand in awe of the remarkable, patient work of the National Academies staff in supporting its deliberations over the course of this study. Staff members kept the committee on track and helped its members to put their ideas and analyses into coherent prose.
Our thanks, finally, to representatives of the sponsoring agencies who worked closely with us when we needed information. Not only did they offer insights in the public sessions during the first committee meetings, but they responded fully and promptly to information requests that we submitted to them throughout the study. The committee accordingly hopes that its findings and recommendations will assist the agencies in moving forward
to assure the design and implementation of a “smarter” OSH surveillance system for the 21st century.
Edward H. Shortliffe, Chair
Committee on Developing a “Smarter” National Surveillance
System for Occupational Safety and Health in the 21st Century
This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.
We thank the following individuals for their review of this report:
James J. Cimino, University of Alabama School of Medicine
Eric Frumin, Change to Win
Erica Groshen, Cornell University
James S. House, University of Michigan
Joel Kaufman, University of Washington
Anthony LaMontagne, Deakin University, Australia
Harold Lehmann, Johns Hopkins School of Medicine
Virginia Lesser, Oregon State Department of Statistics
Sharon Levine, Kaiser Permanente
Barbara Materna, California Department of Public Health
Carrie A. Redlich, Yale University
John W. Ruser, Workers Compensation Research Institute
Gregory R. Wagner, Harvard School of Public Health
Marc Younis, ExxonMobil
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Dr. Mark R. Cullen, Stanford University, and Dr. James A. Merchant, the University of Iowa. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.
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Select Acronyms and Abbreviations
Adult Blood Lead Epidemiology and Surveillance
American Community Survey
Agency for Healthcare Research and Quality
American Thoracic Society
blood lead level
Bureau of Labor Statistics, U.S. Department of Labor
Behavioral Risk Factor Surveillanced System
California Simulation of Insurance Markets
CARcinogen EXposure System
Centers for Disease Control and Prevention
Chemical Exposure Health Data
Commercial Fishing Incident Database
Census of Fatal Occupational Injuries
Code of Federal Regulations
Confidential Information Protection and Statistical Efficiency Act
Chronic Obstructive Pulmonary Disease
Consumer Products Safety Commission
The Center for Construction Research and Training
Center for Surveillance, Epidemiology, and Laboratory Services
Council of State and Territorial Epidemiologists
Center for Workers’ Compensation Studies
Coal Workers’ Health Surveillance Program
Coal Workers’ Pneumoconiosis
Coal Workers’ X-ray Surveillance Program
days away from work
U.S. Department of Energy
U.S. Department of Labor
Division of Safety Research, National Institute for Occupational Safety and Health
electronic health record
Environmental Protection Agency
skin specialist surveillance scheme
European Foundation for the Improvement of Living and Working Conditions
European Working Conditions Survey
Work-Related Lung Disease Surveillance System
Federal Aviation Administration
Fatality Assessment and Control Evaluation
Fatality Analysis Reporting System
Finnish Job Exposure Matrix
Fatalities in the Oil and Gas Extraction Industry
Federal Railroad Administration
The Healthcare Cost and Utilization Project
health hazard evaluation
U.S. Department of Health and Human Services
Health Information Technology for Economic and Clinical Health
human immunodeficiency virus
Health and Safety Executive
Household Survey of Occupational Injuries and Illnesses
International Association of Industrial Accidents Boards and Commissions
International Classification of Diseases
International Classification of Diseases, 10th Revision, Clinical Modification
International Labour Organization
Integrated Management Information System
Institute of Medicine
job exposure matrices
Local Area Unemployment Statistics
Labour Force Survey
Massachusetts Coalition for Occupational Safety and Health
Mine Data Retrieval System
Medical Expenditure Panel Survey
Michigan Fatality Assessment and Control Evaluation
Mine Safety and Health Administration
North American Industry Classification System
National Birth Defects Prevention Study
National Center for Chronic Disease Prevention and Health Promotion
National Council on Compensation Insurance
National Center for Health Statistics
National Center for Injury Prevention and Control
National Compensation Survey
National Crime Victimization Survey
National Electronic Injury Surveillance System
National Health and Nutrition Examination Survey
National Health Interview Survey
National Highway Traffic Safety Administration
National Institutes of Health
NIOSH Industry and Occupation Computerized Coding System
National Institute for Occupational Safety and Health
natural language processing
National Notifiable Diseases Surveillance System
National Occupational Exposures Survey
National Occupational Hazards Survey
National Occupational Mortality Surveillance System
National Occupational Research Agenda
National Opinion Research Center
National Occupational Respiratory Mortality System
National Research Council
Occupational Network Database
OSHA Data Initiative
Occupational Health Safety Network
Occupational Injury and Illness Classification System
OSHA Information System
Office of the National Coordinator for Health Information Technology
Occupational Requirements Survey
Occupational Safety and Health
Occupational Safety and Health Act of 1970
Occupational Safety and Health Administration
personal protective equipment
Pregnancy Risk Assessment Monitoring System
quality-adjusted life year
Quarterly Census of Employment and Wages
Quality of Worklife Survey
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
Sentinel Event Notification System for Occupational Risks
Safety and Health Assessment and Research for Prevention
Standard Occupational Classification
Survey of Occupational Injuries and Illnesses
social return on investment
Social Security Administration
Social Security Disability Insurance
Self-reported Work-related Illness
The Health and Occupation Research network
Trucking Injury Reduction Emphasis through Surveillance
United Automobile, Aerospace and Agricultural Implement Workers of America
Unified Medical Language System
Workers Compensation Insurance Organizations
Web-based Injury Statistics Query and Reporting System
work-related musculoskeletal disorder
Work-Related Injury Statistics Query System
Young Workers Project
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