Burden, Need and Impact

Burden

Manufacturing jobs require work with machinery and tools that can cause injury. Contacts with objects and equipment was the leading cause of death in manufacturing in 2012. It was also the leading cause of days away from work, job transfer, or restriction, with 46,640 cases recorded.^1,2 A NIOSH analysis from 2003 found that these injuries each cost $750,000 on average.³ Smaller businesses in particular face the challenge of remaining competitive, and they often lack an safety and health infrastructure as well as human resource management support. While two-thirds of new small businesses survive at least 2 years, only 44% survive at least 4 years. These numbers are consistent across sectors.³

Need

To reduce the number of injuries and fatalities due to contact with objects and equipment among workers in the manufacturing sector, NIOSH can undertake several activities

• Compile a database of injuries and fatalities and disseminate relevant information to workers and employers.
• Develop and improve manufacturing equipment, interventions and training programs.
• Disseminate design guidelines and machine risk assessment tools by establishing partnerships with trade associations, employers, labor unions and others.

NIOSH is well-suited to demonstrating economically viable practical solutions for small businesses, case studies conducted within small businesses, and studies demonstrating positive return on investment for health and safety efforts within the small business community.

Impact

In a coordinated effort between the NIOSH Manufacturing and Traumatic Injury Programs, NIOSH researchers published a study of saw-related injuries and their causes and compared with national data from the Bureau of Labor Statistics and funded research by extramural scientists providing guidance on safety procedures, safe equipment design and operation related to machine guarding and the control of hazardous energy. The potential for impact of this new evidence involves motivating employers to maintain and improve safety initiatives, but it also can help them identify appropriate types of safety interventions. In addition to emphasizing workplace safety, this report demonstrates the value of reporting systems (such as a claims database) to identify hazards to guide risk assessments. Using empirical data provides appropriate justification for a safety intervention and prioritizes risk mitigation efforts.

Burden

Bureau of Labor Statistics data indicates that Musculoskeletal disorder (MSD) cases requiring days away from work accounted for 32% of all nonfatal occupational injury and illnesses cases in 2014. The MSD incidence rate for manufacturing was 36.3 cases per 10,000 full-time employees (FTE) in 2014.¹ Workers who sustained a MSD required a median of 11 days away from work to recover, an indicator of the severity of these injuries. In 2007, musculoskeletal disorders had a direct cost (medical costs plus indemnity) of $1.5 billion. The indirect costs (lost wages, fringe benefit losses, home production losses, and training, hiring, and disruption costs) amounted to an additional $1.1 billion.²

Need

To reduce the number and severity of MSDs among workers in the manufacturing sector, NIOSH can undertake several activities:

• Conduct surveillance on the number and severity of musculoskeletal disorders among manufacturing sector workers from workers compensation sources.
• Provide intervention tools and engineering controls to reduce the number and severity of musculoskeletal disorders among sector workers.
• Implement activities that move research into practice to prevent musculoskeletal disorders among manufacturing sector workers.

Impact

The NIOSH Manufacturing Program coordinated efforts with the NIOSH Traumatic Injury, Musculoskeletal Health, and Health Hazard Evaluations (HHE) Programs. NIOSH conducted health hazard evaluations of MSD issues in manufacturing, and typical recommendations for addressing MSD risk factors include reducing the weight of the load lifted through engineering or administrative controls and using ergonomic guidelines to design work stations and work tasks. The Musculoskeletal Health Program has pursued the unique opportunity to establish a collaboration with the NIOSH Center for Worker Compensation Studies and the NIOSH Economic Research and Support Office. This collaboration will benefit surveillance and intervention effectiveness research, which could help workers and employers identify effective interventions. Any progress made to lessen the incidence and severity of MSDs would significant improve workers’ health, well-being and could bring significant cost reductions to industry.

Burden

Occupational hearing loss is caused by exposure at work to loud noise or chemicals that damage hearing. Prevention is key because hearing loss is permanent and can have a profound impact on quality of life. It can limit the length and depth of conversations, contributing to social isolation, and diminish enjoyment of everyday pleasures like music and television. For these and other reasons, hearing loss is strongly linked with depression.¹

Safety is also a concern, as people with hearing loss lose situational awareness and are more likely to get injured at home and on the job. As hearing becomes more difficult, people don’t use the hearing-related parts of their brains as much. These parts start to break down, leading to diminished memory and thinking skills in a process called cognitive decline. It is a case of “use it or lose it”.¹

This burden that can be measured using disability-adjusted life years (DALYs). It is an approach that can be used to quantify the impact of hearing loss on critical intangibles, such as communication and mental health. NIOSH found that 2.7 healthy years are lost each year for every 10,000 workers in manufacturing.¹ To further demonstrate the burden of hearing loss, NIOSH has partnered with hearing conservation providers to collect audiometric data from a broad spectrum of sectors. The burden for noise-exposed workers in the Manufacturing sector was approximately 20%.²

Need

To reduce the number and severity of MSDs among workers in the manufacturing sector, NIOSH can undertake several activities:

• Implement surveillance activities to identify and reduce sources of noise exposures, conduct longitudinal analyses of hearing outcomes, implement hearing protection usage guidance, and utilize proven effective engineering noise control solutions.
• Implement research and development activities for identifying effective noise controls, educational outreach, economic cost benefit examples, and quiet-by-design activities for controlling exposure through reducing the noise at the source.
• Implement research and development activities for personal hearing protection devices, effective means of fit-testing protectors, guidance, and educational materials for use of hearing protection in the workplace.
• Implement research activities to identify hearing loss risk factors for impulsive noise in manufacturing.
• Implement research activities to develop metrics of intervention effectiveness for hearing loss prevention to validate consensus standards, and to publicize or assess the effectiveness of hearing conservation program.

Impact

Surveillance also enables NIOSH to identify high-risk groups, guide prevention and research efforts, and evaluate the success or failure of interventions. The intersection of interests and efforts between the NIOSH Manufacturing, Hearing Loss Prevention, and Surveillance Programs led NIOSH to develop a national surveillance system for occupational hearing loss (OHL). As of 2014, NIOSH has partnered with 18 audiometric data providers. Over 10.3 million private sector audiograms of varying quality with related demographic data have been collected and added to a national repository for OHL surveillance data. This effort allowed for the estimation of the prevalence and incidence of hearing loss within manufacturing as well as in other various industries. NIOSH has supported the audiometric component of the National Health and Nutrition Examination Survey (NHANES). The NHANES data have been utilized in the updated International Standards Organization acoustic standard, ISO 1999:2013. ISO 1999 allows estimation of expected hearing loss due to varying intensities and durations of noise exposure during employment. ISO 1999 provides hearing practitioners with normative data against which a particular exposed population can be compared.

NIOSH used two different approaches to address the need for evidence of intervention effectiveness for hearing loss prevention. The first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. The Awards has yielded evidence on the adoption of some of the NIOSH recommended practices by the manufacturing industry.